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The sero-epidemiology of Coxiella burnetii in humans and cattle, Western Kenya: evidence from a cross-sectional study

The sero-epidemiology of Coxiella burnetii in humans and cattle, Western Kenya: evidence from a cross-sectional study
The sero-epidemiology of Coxiella burnetii in humans and cattle, Western Kenya: evidence from a cross-sectional study
Evidence suggests that the intracellular bacterial pathogen Coxiella burnetii (which causes Q fever) is widespread, with a near global distribution. While there has been increasing attention to Q fever epidemiology in high-income settings, a recent systematic review highlighted significant gaps in our understanding of the prevalence, spatial distribution and risk factors for Q fever infection across Africa. This research aimed to provide a One Health assessment of Q fever epidemiology in parts of Western and Nyanza Provinces, Western Kenya, in cattle and humans. A cross-sectional survey was conducted: serum samples from 2049 humans and 955 cattle in 416 homesteads were analysed for C. burnetii antibodies. Questionnaires covering demographic, socio-economic and husbandry information were also administered. These data were linked to environmental datasets based on geographical locations (e.g., land cover). Correlation and spatial-cross correlation analyses were applied to assess the potential link between cattle and human seroprevalence. Multilevel regression analysis was used to assess the relationships between a range of socio-economic, demographic and environmental factors and sero-positivity in both humans and animals. The overall sero-prevalence of C. burnetii was 2.5% in humans and 10.5% in cattle, but we found no evidence of correlation between cattle and human seroprevalence either within households, or when incorporating spatial proximity to other households in the survey. Multilevel modelling indicated the importance of several factors for exposure to the organism. Cattle obtained from market (as opposed to those bred in their homestead) and those residing in areas with lower precipitation levels had the highest sero-prevalence. For humans, the youngest age group had the highest odds of seropositivity, variations were observed between ethnic groups, and frequent livestock contact (specifically grazing and dealing with abortion material) was also a risk factor. These results illustrate endemicity of C. burnetii in western Kenya, although prevalence is relatively low. The analysis indicates that while environmental factors may play a role in cattle exposure patterns, human exposure patterns are likely to be driven more strongly by livestock contacts. The implication of livestock markets in cattle exposure risks suggests these may be a suitable target for interventions.
1935-2735
1-17
Wardrop, Nicola A.
8f3a8171-0727-4375-bc68-10e7d616e176
Thomas, Lian
3a0fd5de-7f0e-405e-9720-f41486eaddb3
Cook, Elizabeth A.J.
70d7e40f-0b67-45a7-93ee-e284fea7525a
de Glanville, William A.
e94a9693-471d-49d9-9bea-ea03cbf82038
Atkinson, Peter M.
96e96579-56fe-424d-a21c-17b6eed13b0b
Wamae, Claire N.
c845b5b3-5b87-4f52-af93-d9b2a3537723
Fèvre, Eric M.
6a168bf3-21be-42c7-b588-7a6b5bad64e5
Wardrop, Nicola A.
8f3a8171-0727-4375-bc68-10e7d616e176
Thomas, Lian
3a0fd5de-7f0e-405e-9720-f41486eaddb3
Cook, Elizabeth A.J.
70d7e40f-0b67-45a7-93ee-e284fea7525a
de Glanville, William A.
e94a9693-471d-49d9-9bea-ea03cbf82038
Atkinson, Peter M.
96e96579-56fe-424d-a21c-17b6eed13b0b
Wamae, Claire N.
c845b5b3-5b87-4f52-af93-d9b2a3537723
Fèvre, Eric M.
6a168bf3-21be-42c7-b588-7a6b5bad64e5

Wardrop, Nicola A., Thomas, Lian, Cook, Elizabeth A.J., de Glanville, William A., Atkinson, Peter M., Wamae, Claire N. and Fèvre, Eric M. (2016) The sero-epidemiology of Coxiella burnetii in humans and cattle, Western Kenya: evidence from a cross-sectional study. PLoS Neglected Tropical Diseases, 10 (10), 1-17. (doi:10.1371/journal.pntd.0005032). (PMID:27716804)

Record type: Article

Abstract

Evidence suggests that the intracellular bacterial pathogen Coxiella burnetii (which causes Q fever) is widespread, with a near global distribution. While there has been increasing attention to Q fever epidemiology in high-income settings, a recent systematic review highlighted significant gaps in our understanding of the prevalence, spatial distribution and risk factors for Q fever infection across Africa. This research aimed to provide a One Health assessment of Q fever epidemiology in parts of Western and Nyanza Provinces, Western Kenya, in cattle and humans. A cross-sectional survey was conducted: serum samples from 2049 humans and 955 cattle in 416 homesteads were analysed for C. burnetii antibodies. Questionnaires covering demographic, socio-economic and husbandry information were also administered. These data were linked to environmental datasets based on geographical locations (e.g., land cover). Correlation and spatial-cross correlation analyses were applied to assess the potential link between cattle and human seroprevalence. Multilevel regression analysis was used to assess the relationships between a range of socio-economic, demographic and environmental factors and sero-positivity in both humans and animals. The overall sero-prevalence of C. burnetii was 2.5% in humans and 10.5% in cattle, but we found no evidence of correlation between cattle and human seroprevalence either within households, or when incorporating spatial proximity to other households in the survey. Multilevel modelling indicated the importance of several factors for exposure to the organism. Cattle obtained from market (as opposed to those bred in their homestead) and those residing in areas with lower precipitation levels had the highest sero-prevalence. For humans, the youngest age group had the highest odds of seropositivity, variations were observed between ethnic groups, and frequent livestock contact (specifically grazing and dealing with abortion material) was also a risk factor. These results illustrate endemicity of C. burnetii in western Kenya, although prevalence is relatively low. The analysis indicates that while environmental factors may play a role in cattle exposure patterns, human exposure patterns are likely to be driven more strongly by livestock contacts. The implication of livestock markets in cattle exposure risks suggests these may be a suitable target for interventions.

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Accepted/In Press date: 9 September 2016
e-pub ahead of print date: 7 October 2016
Published date: 7 October 2016
Organisations: Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 400361
URI: https://eprints.soton.ac.uk/id/eprint/400361
ISSN: 1935-2735
PURE UUID: 6b3da1aa-5080-40a3-af2d-3408e7463242
ORCID for Peter M. Atkinson: ORCID iD orcid.org/0000-0002-5489-6880

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Date deposited: 15 Sep 2016 08:14
Last modified: 15 Aug 2019 00:54

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Contributors

Author: Lian Thomas
Author: Elizabeth A.J. Cook
Author: William A. de Glanville
Author: Peter M. Atkinson ORCID iD
Author: Claire N. Wamae
Author: Eric M. Fèvre

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