This comprehensive literature review provides a helpful consolidation of current evidence on Spotted Fever Group Rickettsiae (SFGR) in Colombia. As emerging tick-borne pathogens causing potentially fatal disease, improved SFGR surveillance and control should be public health priorities.

The review is logically structured and well-written overall. The authors demonstrate expertise in SFGR epidemiology through detailed analysis of molecular detections, vectors, seroprevalence studies, and knowledge gaps. They make a compelling case that limitations in national reporting and physician awareness drive this neglected disease’s health burden.

While informative, the paper would benefit from sharpening the main implications and translating findings to concrete actions. Specifically:

Major Revisions:

1. Critically assess seroprevalence study limitations - assay cross-reactivity, ephemeral antibodies, and variable methods may explain geographic/demographic discrepancies in estimates. Implications?

2. The mismatch between molecular evidence of R. parkeri in vectors and few diagnosed human cases warrants scrutiny. Explore knowledge gaps and hypotheses – are mild cases being missed? Could co-infections or reservoirs explain?

3. Consider land use changes expanding suitable vector habitats and animal reservoirs when theorizing SFGR spread into new regions. Elaborate in the discussion.

4. The review cites evidence that cases are severely underreported and outbreaks likely underestimated in Colombia. Explicitly state 2-3 top recommendations for improving SFGR diagnosis, surveillance, and physician training.

5. Interpret seroprevalence study limitations more critically. Discrepancies across geographic regions and populations may stem from assay cross-reactivity, inconsistent methods, or ephemeral antibodies. Discuss implications.

6. The literature review methods are appropriate but should state exact search dates, databases, and keywords used for completeness and reproducibility.

7. As a standalone figure, the map of described SFGR species lacks sufficient context on locations, vectors, dates, etc. to interpret pathogen distribution.

8. Given infection evidence in vectors, theorize reasons for the stark mismatch with few diagnosed human R. parkeri cases. Explore knowledge gaps.

9. Weave in increased relevance of animal reservoirs and land use changes that may expand SFGR suitable habitats.

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