Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014.

Autor:	Pisharody S; Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina., Rubach MP; Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina.; Duke Global Health Institute, Duke University, Durham, North Carolina.; Programme in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania., Carugati M; Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina., Nicholson WL; Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia., Perniciaro JL; Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia., Biggs HM; Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina., Maze MJ; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Centre for International Health, University of Otago, Dunedin, New Zealand.; Department of Medicine, University of Otago, Christchurch, New Zealand., Hertz JT; Duke Global Health Institute, Duke University, Durham, North Carolina., Halliday JEB; Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.; Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom., Allan KJ; Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.; Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom., Mmbaga BT; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Saganda W; Mawenzi Regional Referral Hospital, Moshi, Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania., Lwezaula BF; Mawenzi Regional Referral Hospital, Moshi, Tanzania.; Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania., Kazwala RR; Sokoine University of Agriculture, Morogoro, Tanzania., Cleaveland S; Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom.; Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom., Maro VP; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Crump JA; Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina.; Duke Global Health Institute, Duke University, Durham, North Carolina.; Kilimanjaro Christian Medical Centre, Moshi, Tanzania.; Centre for International Health, University of Otago, Dunedin, New Zealand.; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Jazyk:	angličtina
Zdroj:	The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2021 Dec 20; Vol. 106 (2), pp. 494-503. Date of Electronic Publication: 2021 Dec 20.
DOI:	10.4269/ajtmh.20-1036
Abstrakt:	Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance-coupling case-finding at two referral hospitals and healthcare utilization data-we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007-2008) or Rickettsia africae (2012-2014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20-454) and 147 (uncertainty range, 52-645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24-163) and 75 (uncertainty range, 34-176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.
Databáze:	MEDLINE
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