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

2021 ◽  
Author(s):  
Sruti Pisharody ◽  
Matthew P. Rubach ◽  
Manuela Carugati ◽  
William L. Nicholson ◽  
Jamie L. Perniciaro ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Q Fever ◽  
Spotted Fever ◽  
Annual Incidence ◽  
Sub Saharan Africa ◽  
Spotted Fever Group ◽  
Uncertainty Range ◽  
Northern Tanzania ◽  
Utilization Data ◽  
Acute Q Fever

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.

scholarly journals Knowledge, attitudes and practices towards spotted fever group rickettsioses and Q fever in Laikipia and Maasai Mara, Kenya

2016 ◽  
Author(s):  
David Ndeereh ◽  
Gerald Muchemi ◽  
Andrew Thaiyah
Keyword(s):  
Q Fever ◽  
Spotted Fever ◽  
Medical Personnel ◽  
Raw Milk ◽  
Sub Saharan Africa ◽  
Spotted Fever Group ◽  
Health Providers ◽  
Attitudes And Practices ◽  
Local Residents ◽  
Sub Saharan

Many factors contribute to misdiagnosis and underreporting of infectious zoonotic diseases in most sub-Saharan Africa including limited diagnostic capacity and poor knowledge. We assessed the knowledge, practices and attitudes towards spotted fever group rickettsioses (SFGR) and Q fever amongst local residents in Laikipia and Maasai Mara in Kenya. A semistructured questionnaire was administered to a total of 101 respondents including 51 pastoralists, 17 human health providers, 28 wildlife sector personnel and 5 veterinarians. The pastoralists expressed no knowledge about SFGR and Q fever. About 26.7% of the wildlife sector personnel in Laikipia expressed some knowledge about SFGR and none in Maasai Mara. None of these respondents had knowledge about Q fever. About 45.5 and 33.3% of the health providers in Laikipia and Maasai Mara respectively expressed knowledge about SFGR and 9.1% in Laikipia expressed good knowledge on Q fever and none in Maasai Mara. The diseases are not considered amongst potential causes of febrile illnesses in most medical facilities except in one facility in Laikipia. Majority of pastoralists practiced at least one predisposing activity for transmission of the diseases including consumption of raw milk, attending to parturition and sharing living accommodations with livestock. Education efforts to update knowledge on medical personnel and One-Health collaborations should be undertaken for more effective mitigation of zoonotic disease threats. The local communities should be sensitized through a multidisciplinary approach to avoid practices that can predispose them to the diseases.

scholarly journals Q Fever, Spotted Fever Group, and Typhus Group Rickettsioses Among Hospitalized Febrile Patients in Northern Tanzania

2011 ◽  
Vol 53 (4) ◽  
pp. e8-e15 ◽  
Author(s):  
M. Prabhu ◽  
W. L. Nicholson ◽  
A. J. Roche ◽  
G. J. Kersh ◽  
K. A. Fitzpatrick ◽  
...  
Keyword(s):  
Q Fever ◽  
Spotted Fever ◽  
Spotted Fever Group ◽  
Northern Tanzania

Rickettsial Diseases

2017 ◽  
Author(s):  
Lisa Sun ◽  
Michael V. Johnston
Keyword(s):  
Endothelial Cells ◽  
Q Fever ◽  
Spotted Fever ◽  
The United States ◽  
Dermacentor Variabilis ◽  
Farm Animals ◽  
Spotted Fever Group ◽  
Rocky Mountain Spotted Fever ◽  
The World ◽  
The Brain

Tick-borne rickettsioses are emerging as more important health problems throughout the world. The spotted fever group including Rickettsia rickettsia can cause encephalopathy, meningitis and brain damage by selectively targeting capillary endothelial cells in the brain, and stimulating inflammation, capillary leakage, hemorrhage, and intravascular coagulation. Rickettsia are are arthropod-borne gram-negative coccobacilli bacteria and are obligate intracellular organisms that do not survive in artificial medium. In North and South America, the most common rickettsial disorder is rocky mountain spotted fever (RMSF) transmitted by the dog tick Dermacentor variabilis or the wood tick Dermacentor andersoni. A characteristic “starry sky” pattern can be seen on MRI imaging of the brain in some patients with RMSF encephalopathy and is thought to reflect the organisms targeting of brain endothelial cells in capillaries the white matter. Early treatment with doxycycline is curative and reverses signs of encephalopathy if given within a few day of onset, but delayed treatment can be associated with permanent neurological disability. The typhus group of rickettsia bacteria include R. prowazekii, which causes epidemic typhus and R. typhi, which causes murine typhus (endemic) typhus in tropical and subtropical parts of the world. Flying squirrels and humans carry R prowazekii and rats are carry R. typhi. Q fever caused by the rickettsia organism Coxiella burnetti is transmitted from farm animals including sheep and is seen throughout the world including the United States.

scholarly journals Incidence of Acute Myocardial Infarction in Northern Tanzania: A Modeling Approach Within a Prospective Observational Study

2021 ◽  
Author(s):  
Julian T. Hertz ◽  
Deng B. Madut ◽  
Matthew P. Rubach ◽  
Gwamaka William ◽  
John A. Crump ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Chest Pain ◽  
Community Survey ◽  
Annual Incidence ◽  
Sub Saharan Africa ◽  
Surveillance Study ◽  
Shortness Of Breath ◽  
Northern Tanzania ◽  
Sub Saharan

Background Rigorous incidence data for acute myocardial infarction (AMI) in sub‐Saharan Africa are lacking. Consequently, modeling studies based on limited data have suggested that the burden of AMI and AMI‐associated mortality in sub‐Saharan Africa is lower than in other world regions. Methods and Results We estimated the incidence of AMI in northern Tanzania in 2019 by integrating data from a prospective surveillance study (681 participants) and a community survey of healthcare‐seeking behavior (718 participants). In the surveillance study, adults presenting to an emergency department with chest pain or shortness of breath were screened for AMI with ECG and troponin testing. AMI was defined by the Fourth Universal Definition of AMI criteria. Mortality was assessed 30 days following enrollment via in‐person or telephone interviews. In the cluster‐based community survey, adults in northern Tanzania were asked where they would present for chest pain or shortness of breath. Multipliers were applied to account for AMI cases that would have been missed by our surveillance methods. The estimated annual incidence of AMI was 172 (207 among men and 139 among women) cases per 100 000 people. The age‐standardized annual incidence was 211 (263 among men and 170 among women) per 100 000 people. The estimated annual incidence of AMI‐associated mortality was 87 deaths per 100 000 people, and the age‐standardized annual incidence was 102 deaths per 100 000 people. Conclusions The incidence of AMI and AMI‐associated mortality in northern Tanzania is much higher than previously estimated and similar to that observed in high‐income countries.

Infections due to Rickettsia and Related Organisms

2017 ◽  
Author(s):  
Lucas S Blanton
Keyword(s):  
Q Fever ◽  
Spotted Fever ◽  
Dynamic Change ◽  
Clinical Manifestations ◽  
Rocky Mountain ◽  
Febrile Illness ◽  
American Southwest ◽  
Diagnostic Methods ◽  
Spotted Fever Group ◽  
Rocky Mountain Spotted Fever

Infections caused by organisms of the genus Rickettsia, Orientia, Ehrlichia, Anaplasma, and Coxiella occur throughout the world and are important, yet often overlooked, causes of febrile illness. They are transmitted by ticks, lice, mites, fleas, and, in the case of Coxiella, infected aerosols. Some are considered emerging and reemerging infectious diseases, as exemplified by the emergence of Rocky Mountain spotted fever in the American Southwest and Mexico; the reemergence of murine typhus in parts of Texas; and the discovery of new pathogens, such as Ehrlichia muris–like agent. Manifestations are usually of an acute undifferentiated febrile illness, with associated headache, malaise, myalgias, and varying frequency of rash. Since confirmation of diagnosis is often retrospective, requiring the dynamic change in antibody titers from acute and convalescent phase sera, clinical recognition for empirical treatment is imperative. Indeed, timely treatment is effective at abating symptoms and preventing complications. This review discusses important aspects of the epidemiology, clinical manifestations, diagnostic methods, and treatment of infections caused by Rickettsia and related organisms.  This review contains 5 figures, 9 tables, and 50 references. Key words: anaplasmosis, ehrlichiosis, Q fever, Rocky Mountain spotted fever, scrub typhus, spotted fever group rickettsioses, typhus group rickettsioses

scholarly journals Leptospirosis and Rickettsial Diseases Sero-Conversion Surveillance Among U.S. Military Personnel in Honduras

2021 ◽  
Author(s):  
Chien-Chung Chao ◽  
Zhiwen Zhang ◽  
Tatyana Belinskaya ◽  
Hua-Wei Chen ◽  
Wei-Mei Ching
Keyword(s):  
Military Personnel ◽  
Q Fever ◽  
Spotted Fever ◽  
Seroconversion Rate ◽  
Severe Infection ◽  
Epidemiological Data ◽  
Medical Attention ◽  
Spotted Fever Group ◽  
Igg Antibodies ◽  
Rickettsial Diseases

ABSTRACT Introduction Leptospirosis and rickettsial diseases are global zoonotic diseases. In severe infection cases, mortality can range from 10% to 30%. Currently most epidemiological data available are based on outbreak investigations and hospital-based studies from endemic countries. The U.S. soldiers at military bases in these countries are highly vulnerable due to the fact that most of them are immunologically naïve to these pathogens. No risk assessment of leptospirosis and rickettsial diseases among U.S. military personnel in Honduras is currently available. This study was aimed at determining the prevalence of leptospirosis and rickettsial diseases in U.S. military personnel deployed to Honduras using serological assays. Materials and Methods A cohort of pre- and post-deployment sera from the most recent 1,000 military personnel stationed in Honduras for at least 6 months between 2000 and 2016 was identified for this study. Serum specimens from these eligible subjects were retrieved. All post-deployment serum specimens were screened at a dilution of 1:100 for the presence of IgG antibodies to Leptospira and Rickettsia pathogens. The pre-deployment sera from those individuals with post-deployment IgG antibodies above cutoff (i.e., seropositive) were tested to determine seroconversion. Seroconversion was defined as conversion of an optical density value from below the cutoff (i.e., negative) in a pre-deployed specimen to above the cutoff (i.e., positive) in a post-deployed specimen at a titer of 100. Results The seropositive post-deployment specimens for antibodies against Leptospira (causing leptospirosis), Rickettsia typhi (causing murine typhus [MT]), spotted fever group rickettsioses (SFGR, causing SFG Rickettsia), Orientia tsutsugamushi (causing scrub typhus [ST]), and Coxiella burnetii (causing Q fever [QF]) were 11.6%, 11.3%, 6%, 5.6%, and 8.0%, respectively. The seroconverted rate in those assigned to Honduras from 2000 to 2016 was 7.3%, 1.9%, 3.9%, 4.3%, and 2.7% for leptospirosis, MT, SFGR, ST, and QF, respectively. Among the seroconverted specimens, 27 showed seroconversion of at least two antibodies. These seroconverted individuals accounted for 8.8% (3 out of 34) of the personnel who looked for medical attention during their deployment. Conclusions Our results suggest a leptospirosis seroconversion rate of 7.3%, which is higher than the 0.9% and 3.9% seroconversion in Korea and Japan, respectively. The higher rate of seroconversion indicates potential risk of Leptospira exposure. Additional testing of water samples in the pools and pits around the training sites to locate the infected areas is important to eliminate or reduce future exposure to Leptospira during trainings. The rates of seroconversion for ST, MT, spotted fever Rickettsia, and QF were 4.3%, 1.9%, 3.9%, and 2.7%, respectively, indicating the potential exposure to a variety of rickettsial-related pathogens. Testing of vectors for rickettsial pathogens in the areas could inform effective vector control countermeasures to prevent exposure. Proper precaution and protective measures are needed to better protect military personnel deployed to Honduras.

scholarly journals Q Fever with Unusual Exposure History: A Classic Presentation of a Commonly Misdiagnosed Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Randall J. Nett ◽  
Earl Book ◽  
Alicia D. Anderson
Keyword(s):  
Coxiella Burnetii ◽  
Laboratory Testing ◽  
Q Fever ◽  
Spotted Fever ◽  
Rocky Mountain ◽  
Rocky Mountain Spotted Fever ◽  
Laboratory Confirmation ◽  
Exposure History ◽  
Acute Q Fever

We describe the case of a man presumptively diagnosed and treated for Rocky Mountain spotted fever following exposure to multiple ticks while riding horses. The laboratory testing of acute and convalescent serum specimens led to laboratory confirmation of acute Q fever as the etiology. This case represents a potential tickborne transmission ofCoxiella burnetiiand highlights the importance of considering Q fever as a possible diagnosis following tick exposures.

scholarly journals DIAGNOSTIC SIGNIFICANCE OF ANTIBODIES SPECTRUM TO COXIELLA BURNETII IN I AND II PHASES

2018 ◽  
Vol 23 (4) ◽  
pp. 165-171
Author(s):  
Tatiana A. Chekanova ◽  
S. N. Shpynov ◽  
S. Zh. Netalieva ◽  
M. A. Babaeva
Keyword(s):  
Viral Infection ◽  
Coxiella Burnetii ◽  
Q Fever ◽  
Spotted Fever ◽  
Unknown Etiology ◽  
Serological Markers ◽  
Serological Testing ◽  
Diagnostic Significance ◽  
Acute Respiratory Viral Infection ◽  
Acute Q Fever

The article discusses the results of a retrospective study for the presence of Coxiellosis serological markers in 723 blood sera from 537 febrile patients hospitalized in May-September 2015 in the regional infectious hospital in the Astrakhan region. Blood sera were screened by ELISA for the presence of IgG and IgM to II phase Coxiella burnetii (IgG II and IgM II, respectively). Samples, containing IgG II, wear detected IgG to I phase C. burnetii (IgG I). 92 seropositive C. burnetii patients (including 15 children’s) were identified. Characteristics of the antibody profiles in this study (IgG II, IgG II + IgM II, IgG II + IgG I, IgG II + IgM II + IgG I, IgM II) and their titers were given. The clinical picture is typical for acute infectious diseases was more often noted (diagnoses - acute respiratory disease / acute respiratory viral infection, adenovirus infection, Astrakhan spotted fever, coxiellosis) at spectrum detecting IgM II, IgM II + IgG II or IgG II (1: 800-1: 1600 titters). The «unknown etiology viral infection» diagnosis was more common among adults with any possible antibodies spectrum. Diagnostic criteria of acute Q fever and chronic coxsiellosis are discussed in the context of the serological testing results.

scholarly journals Molecular surveillance of spotted fever group rickettsioses in wildlife and detection of Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela) in Kenya

2017 ◽  
Vol 84 (1) ◽  
Author(s):  
David Ndeereh ◽  
Andrew Thaiyah ◽  
Gerald Muchemi ◽  
Antoinette A. Miyunga
Keyword(s):  
Citrate Synthase ◽  
Spotted Fever ◽  
Intergenic Spacer ◽  
Sub Saharan Africa ◽  
Spotted Fever Group ◽  
Wild Animals ◽  
Rickettsia Species ◽  
Glta Gene ◽  
Sub Saharan ◽  
Rickettsia Sibirica

Spotted fever group rickettsioses are a group of tick-borne zoonotic diseases caused by intracellular bacteria of the genus Rickettsia. The diseases are widely reported amongst international travellers returning from most sub-Saharan Africa with fever, yet their importance in local populations largely remains unknown. Although this has started to change and recently there have been increasing reports of the diseases in livestock, ticks and humans in Kenya, they have not been investigated in wildlife. We examined the presence, prevalence and species of Rickettsia present in wildlife in two regions of Kenya with a unique human–wildlife–livestock interface. For this purpose, 79 wild animals in Laikipia County and 73 in Maasai Mara National Reserve were sampled. DNA extracted from blood was tested using the polymerase chain reaction (PCR) to amplify the intergenic spacer rpmE-tRNAfMet and the citrate synthase-encoding gene gltA. Rickettsial DNA was detected in 2 of the 79 (2.5%) animals in Laikipia and 4 of the 73 (5.5%) in Maasai Mara. The PCR-positive amplicons of the gltA gene were sequenced to determine the detected Rickettsia species. This revealed Rickettsia sibirica in a Topi (Damaliscus lunatus ssp. jimela). This is the first report of spotted fever group rickettsioses in wildlife and the first to report R. sibirica in Kenya. The finding demonstrates the potential role of wild animals in the circulation of the diseases.

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