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Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Q fever is an old and neglected zoonotic disease in Kenya: a systematic review

Authors: J. Njeru, K. Henning, M. W. Pletz, R. Heller, H. Neubauer

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Q fever is a neglected zoonosis caused by the bacterium Coxiella burnetii. The knowledge of the epidemiology of Q fever in Kenya is limited with no attention to control and prevention programs. The purpose of this review is to understand the situation of Q fever in human and animal populations in Kenya in the past 60 years, and help identify future research priorities for the country.

Methods

Databases were searched for national and international scientific studies or reports on Q fever. We included studies and reports published between 1950 and 2015 if they reported on Q fever prevalence, incidence, and infection control programs in Kenya. Data were extracted with respect to studies on prevalence of Coxiella infections, study design, study region, the study populations involved, and sorted according to the year of the study.

Results

We identified 15 studies and reports which qualified for data extraction. Human seroprevalence studies revealed evidence of C. burnetii infections ranging from 3 to 35.8 % in all regions in which surveys were made and two Q fever outbreak episodes. Coxiella burnetii infections found in cattle 7.4–51.1 %, sheep 6.7–20 %, camels 20–46 %, and goats 20–46 % revealed variation based on ecoregions and the year of study. Farming and lack of protective clothing were associated with increased seropositivity among humans. However, high quality data is lacking on Q fever awareness, underlying cultural-economic factors influencing C. burnetii infection, and how the pathogen cycles may be embedded in livestock production and management systems in the economically and ecologically different Kenyan regions. We found no studies on national disease incidence estimates or disease surveillance and control efforts.

Conclusion

Coxiella burnetii infections are common in human and in a wide range of animal populations but are still unrecognized and underestimated thus presenting a significant human and animal health threat in Kenya. The factors influencing pathogen transmission, persistence and spread are poorly understood. Integrated disease surveillance and prevention/control programs are needed in Kenya.
Literature
1.
go back to reference De Lange MM, Schimmer B, Vellema P, Hautvast JL, Schneeberger PM, Van Duijnhoven YT. Coxiella burnetii seroprevalence and risk factors in sheep farmers and farm residents in The Netherlands. Epidemiol Infect. 2014;142(6):1231–44.CrossRefPubMedPubMedCentral De Lange MM, Schimmer B, Vellema P, Hautvast JL, Schneeberger PM, Van Duijnhoven YT. Coxiella burnetii seroprevalence and risk factors in sheep farmers and farm residents in The Netherlands. Epidemiol Infect. 2014;142(6):1231–44.CrossRefPubMedPubMedCentral
2.
go back to reference Maurin M, Raoult D. Q fever. Clin Microb Rev. 1999;12:518–53. Maurin M, Raoult D. Q fever. Clin Microb Rev. 1999;12:518–53.
3.
go back to reference Mege JL, Maurin M, Capo C, Raoult D. Coxiella burnetii. the ‘query’ fever bacterium. A model of immune subversion by a strictly intracellular microorganism. FEMS microb Rev. 1997;19(4):209–17. Mege JL, Maurin M, Capo C, Raoult D. Coxiella burnetii. the ‘query’ fever bacterium. A model of immune subversion by a strictly intracellular microorganism. FEMS microb Rev. 1997;19(4):209–17.
4.
go back to reference Khalili M, Shahabi-Nejad N, Golchin M. Q fever serology in febrile patients in southeast Iran. Trans R Soc Trop Med Hyg. 2010;104(9):623–4.CrossRefPubMed Khalili M, Shahabi-Nejad N, Golchin M. Q fever serology in febrile patients in southeast Iran. Trans R Soc Trop Med Hyg. 2010;104(9):623–4.CrossRefPubMed
5.
go back to reference Slavin G. ‘Q’fever: the domestic animal as a source of infection for man. Vet Rec. 1952;64. Slavin G. ‘Q’fever: the domestic animal as a source of infection for man. Vet Rec. 1952;64.
6.
go back to reference Benenson A, Tigertt W. Studies on Q fever in man. Trans Assoc Am Physicians. 1955;69:98–104. Benenson A, Tigertt W. Studies on Q fever in man. Trans Assoc Am Physicians. 1955;69:98–104.
7.
go back to reference Sidi-Boumedine K, Rousset E, Henning K, Ziller M, Niemczuck K, Roest H, et al. Development of harmonised schemes for the monitoring and reporting of Q-fever in animals in the European Union, EFSA Scientific report. 2010. p. 1–48. Sidi-Boumedine K, Rousset E, Henning K, Ziller M, Niemczuck K, Roest H, et al. Development of harmonised schemes for the monitoring and reporting of Q-fever in animals in the European Union, EFSA Scientific report. 2010. p. 1–48.
8.
go back to reference Bernard H, Brockmann SO, Kleinkauf N, Klinc C, Wagner-Wiening C, Stark K, et al. High seroprevalence of Coxiella burnetii antibodies in veterinarians associated with cattle obstetrics, Bavaria, 2009. Vector Borne Zoonotic Dis. 2012;12(7):552–7.CrossRefPubMed Bernard H, Brockmann SO, Kleinkauf N, Klinc C, Wagner-Wiening C, Stark K, et al. High seroprevalence of Coxiella burnetii antibodies in veterinarians associated with cattle obstetrics, Bavaria, 2009. Vector Borne Zoonotic Dis. 2012;12(7):552–7.CrossRefPubMed
10.
go back to reference Schimmer B, Lenferink A, Schneeberger P, Aangenend H, Vellema P, Hautvast J, et al. Seroprevalence and risk factors for Coxiella burnetii (Q fever) seropositivity in dairy goat farmers’ households in The Netherlands, 2009–2010. PLoS One. 2012;7(7), e42364.CrossRefPubMedPubMedCentral Schimmer B, Lenferink A, Schneeberger P, Aangenend H, Vellema P, Hautvast J, et al. Seroprevalence and risk factors for Coxiella burnetii (Q fever) seropositivity in dairy goat farmers’ households in The Netherlands, 2009–2010. PLoS One. 2012;7(7), e42364.CrossRefPubMedPubMedCentral
12.
go back to reference de Rooij MM, Schimmer B, Versteeg B, Schneeberger P, Berends BR, Heederik D, et al. Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students. PLoS One. 2012;7(2), e32108.CrossRefPubMedPubMedCentral de Rooij MM, Schimmer B, Versteeg B, Schneeberger P, Berends BR, Heederik D, et al. Risk factors of Coxiella burnetii (Q fever) seropositivity in veterinary medicine students. PLoS One. 2012;7(2), e32108.CrossRefPubMedPubMedCentral
13.
go back to reference Crump JA, Morrissey AB, Nicholson WL, Massung RF, Stoddard RA, Galloway RL, et al. Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study. PLoS Negl Trop Dis. 2013;7(7), e2324.CrossRefPubMedPubMedCentral Crump JA, Morrissey AB, Nicholson WL, Massung RF, Stoddard RA, Galloway RL, et al. Etiology of severe non-malaria febrile illness in Northern Tanzania: a prospective cohort study. PLoS Negl Trop Dis. 2013;7(7), e2324.CrossRefPubMedPubMedCentral
14.
go back to reference Vanderburg S, Rubach MP, Halliday JE, Cleaveland S, Reddy EA, Crump JA. Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review. PLoS Negl Trop Dis. 2014;8(4), e2787.CrossRefPubMedPubMedCentral Vanderburg S, Rubach MP, Halliday JE, Cleaveland S, Reddy EA, Crump JA. Epidemiology of Coxiella burnetii infection in Africa: a OneHealth systematic review. PLoS Negl Trop Dis. 2014;8(4), e2787.CrossRefPubMedPubMedCentral
15.
go back to reference Epelboin L, Chesnais C, Boullé C, Drogoul A-S, Raoult D, Djossou F, et al. Q fever pneumonia in French Guiana: prevalence, risk factors, and prognostic score. Clin Infect Dis. 2012;55(1):67–74.CrossRefPubMed Epelboin L, Chesnais C, Boullé C, Drogoul A-S, Raoult D, Djossou F, et al. Q fever pneumonia in French Guiana: prevalence, risk factors, and prognostic score. Clin Infect Dis. 2012;55(1):67–74.CrossRefPubMed
16.
go back to reference Manock SR, Jacobsen KH, de Bravo NB, Russell KL, Negrete M, Olson JG, et al. Etiology of acute undifferentiated febrile illness in the Amazon basin of Ecuador. Am J Trop Med Hyg. 2009;81(1):146–51.PubMed Manock SR, Jacobsen KH, de Bravo NB, Russell KL, Negrete M, Olson JG, et al. Etiology of acute undifferentiated febrile illness in the Amazon basin of Ecuador. Am J Trop Med Hyg. 2009;81(1):146–51.PubMed
17.
go back to reference Knobel DL, Maina AN, Cutler SJ, Ogola E, Feikin DR, Junghae M, et al. Coxiella burnetii in humans, domestic ruminants, and ticks in rural western Kenya. Am J Trop Med Hyg. 2013;88(3):513–8.CrossRefPubMedPubMedCentral Knobel DL, Maina AN, Cutler SJ, Ogola E, Feikin DR, Junghae M, et al. Coxiella burnetii in humans, domestic ruminants, and ticks in rural western Kenya. Am J Trop Med Hyg. 2013;88(3):513–8.CrossRefPubMedPubMedCentral
18.
go back to reference Prabhu M, Nicholson WL, Roche AJ, Kersh GJ, Fitzpatrick KA, Oliver LD, et al. Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis. 2011;53(4):e8–15.CrossRefPubMedPubMedCentral Prabhu M, Nicholson WL, Roche AJ, Kersh GJ, Fitzpatrick KA, Oliver LD, et al. Q fever, spotted fever group, and typhus group rickettsioses among hospitalized febrile patients in northern Tanzania. Clin Infect Dis. 2011;53(4):e8–15.CrossRefPubMedPubMedCentral
19.
go back to reference Makungu C, Gwakisa PS. Community knowledge and attitudes and health workers’ practices regarding non-malaria febrile illnesses in eastern Tanzania. PLoS Negl Trop Dis. 2014;8(5), e2896.CrossRefPubMedPubMedCentral Makungu C, Gwakisa PS. Community knowledge and attitudes and health workers’ practices regarding non-malaria febrile illnesses in eastern Tanzania. PLoS Negl Trop Dis. 2014;8(5), e2896.CrossRefPubMedPubMedCentral
20.
go back to reference To H, Htwe KK, Kako N, Kim HJ, Yamaguchi T, Fukushi H, et al. Prevalence of Coxiella burnetii infection in dairy cattle with reproductive disorders. J Vet Med Sci. 1998;60(7):859–61.CrossRefPubMed To H, Htwe KK, Kako N, Kim HJ, Yamaguchi T, Fukushi H, et al. Prevalence of Coxiella burnetii infection in dairy cattle with reproductive disorders. J Vet Med Sci. 1998;60(7):859–61.CrossRefPubMed
21.
go back to reference Angelakis E, Million M, D’Amato F, Rouli L, Richet H, Stein A, et al. Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis. 2013;32(3):361–8.CrossRefPubMed Angelakis E, Million M, D’Amato F, Rouli L, Richet H, Stein A, et al. Q fever and pregnancy: disease, prevention, and strain specificity. Eur J Clin Microbiol Infect Dis. 2013;32(3):361–8.CrossRefPubMed
22.
go back to reference Beaudeau F, Guatteo R, Seegers H. Excretion of Coxiella burnetii by dairy cows: consequences for disease screening and control. Épidémiol et Santé Anim. 2006;49:1–4. Beaudeau F, Guatteo R, Seegers H. Excretion of Coxiella burnetii by dairy cows: consequences for disease screening and control. Épidémiol et Santé Anim. 2006;49:1–4.
23.
go back to reference Guatteo R, Beaudeau F, Berri M, Rodolakis A, Joly A, Seegers H. Shedding routes of Coxiella burnetii in dairy cows: implications for detection and control. Vet Res. 2006;37(6):827–33.CrossRefPubMed Guatteo R, Beaudeau F, Berri M, Rodolakis A, Joly A, Seegers H. Shedding routes of Coxiella burnetii in dairy cows: implications for detection and control. Vet Res. 2006;37(6):827–33.CrossRefPubMed
24.
go back to reference Fishbein DB, Raoult D. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am J Trop Med Hyg. 1992;47(1):35–40.PubMed Fishbein DB, Raoult D. A cluster of Coxiella burnetii infections associated with exposure to vaccinated goats and their unpasteurized dairy products. Am J Trop Med Hyg. 1992;47(1):35–40.PubMed
25.
go back to reference Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, et al. Diagnosis and management of Q fever-United States, 2013: recommendations from CDC and the Q fever working group. MMWR Recomm Rep. 2013;62(RR-03):1–30.PubMed Anderson A, Bijlmer H, Fournier PE, Graves S, Hartzell J, Kersh GJ, et al. Diagnosis and management of Q fever-United States, 2013: recommendations from CDC and the Q fever working group. MMWR Recomm Rep. 2013;62(RR-03):1–30.PubMed
26.
go back to reference Harris BP. Q-fever in Nairobi. East Afr Med J. 1952;29(4):128–30.PubMed Harris BP. Q-fever in Nairobi. East Afr Med J. 1952;29(4):128–30.PubMed
28.
go back to reference Brotherston JC, Cooke ER. Q fever in Kenya. East Afr Med J. 1956;33(4):125–30.PubMed Brotherston JC, Cooke ER. Q fever in Kenya. East Afr Med J. 1956;33(4):125–30.PubMed
29.
go back to reference Vanek E, Thimm B. Q fever in Kenya. Serological investigations in man and domestic animals. East Afr Med J. 1976;53(12):678–84.PubMed Vanek E, Thimm B. Q fever in Kenya. Serological investigations in man and domestic animals. East Afr Med J. 1976;53(12):678–84.PubMed
30.
go back to reference Potasman I, Rzotkiewicz S, Pick N, Keysary A. Outbreak of Q fever following a safari trip. Clin Infect Dis. 2000;30(1):214–5.CrossRefPubMed Potasman I, Rzotkiewicz S, Pick N, Keysary A. Outbreak of Q fever following a safari trip. Clin Infect Dis. 2000;30(1):214–5.CrossRefPubMed
32.
go back to reference Ta TH, Jimenez B, Navarro M, Meije Y, Gonzalez FJ, Lopez-Velez R. Q Fever in returned febrile travelers. J travel med. 2008;15(2):126–9.CrossRefPubMed Ta TH, Jimenez B, Navarro M, Meije Y, Gonzalez FJ, Lopez-Velez R. Q Fever in returned febrile travelers. J travel med. 2008;15(2):126–9.CrossRefPubMed
33.
go back to reference Cook EG, William A, Thomas LF, Bronsvoort BM, Kariuki S, Fèvre EM. Slaughterhouse zoonoses: Leptospirosis and Q fever in Kenya. Amsterdam: International One Health Congress; 2014. Cook EG, William A, Thomas LF, Bronsvoort BM, Kariuki S, Fèvre EM. Slaughterhouse zoonoses: Leptospirosis and Q fever in Kenya. Amsterdam: International One Health Congress; 2014.
34.
go back to reference Mwololo DK, Wanyoike PM, Bett B. Seroprevalence and risk factors of Coxiella burnetii (Q fever) infection among humans in Bura irrigation scheme. Tana River County: Biennial Scientific Conference and exhibition of the Faculty of Veterinary Medicine; 2014. Mwololo DK, Wanyoike PM, Bett B. Seroprevalence and risk factors of Coxiella burnetii (Q fever) infection among humans in Bura irrigation scheme. Tana River County: Biennial Scientific Conference and exhibition of the Faculty of Veterinary Medicine; 2014.
35.
go back to reference Brown RD. Q fever-veterinary aspects. East Afr Med J. 1956;33(11):441–5.PubMed Brown RD. Q fever-veterinary aspects. East Afr Med J. 1956;33(11):441–5.PubMed
36.
go back to reference Heisch RB. The isolation of Rickettsia burnetii from Lemniscomys sp. in Kenya. East Afr Med J. 1960;37:104.PubMed Heisch RB. The isolation of Rickettsia burnetii from Lemniscomys sp. in Kenya. East Afr Med J. 1960;37:104.PubMed
37.
go back to reference DePuy W, Benka V, Massey A, Deem S, Kinnaird M, O’Brien T, et al. Q Fever risk across a dynamic, Heterogeneous Landscape in Laikipia County, Kenya. EcoHealth. 2014;11(3):429–33.CrossRefPubMed DePuy W, Benka V, Massey A, Deem S, Kinnaird M, O’Brien T, et al. Q Fever risk across a dynamic, Heterogeneous Landscape in Laikipia County, Kenya. EcoHealth. 2014;11(3):429–33.CrossRefPubMed
38.
go back to reference Vogel LC, Muller AS, Odingo RS. Health and Diseases in Kenya. 1st ed. East African Literature Bureau Nairobi: 1974. Vogel LC, Muller AS, Odingo RS. Health and Diseases in Kenya. 1st ed. East African Literature Bureau Nairobi: 1974.
39.
go back to reference Heisch RB, Grainger WE, Harvey AEC, Lister G. Feral aspects of Rickettsial infections in Kenya. Trans R Soc Trop Med Hyg. 1962;56(4):272–82.CrossRefPubMed Heisch RB, Grainger WE, Harvey AEC, Lister G. Feral aspects of Rickettsial infections in Kenya. Trans R Soc Trop Med Hyg. 1962;56(4):272–82.CrossRefPubMed
40.
go back to reference Amexo M, Tolhurst R, Barnish G, Bates I. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet. 2004;364(9448):1896–8.CrossRefPubMed Amexo M, Tolhurst R, Barnish G, Bates I. Malaria misdiagnosis: effects on the poor and vulnerable. Lancet. 2004;364(9448):1896–8.CrossRefPubMed
41.
go back to reference Kallander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia-policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed Kallander K, Nsungwa-Sabiiti J, Peterson S. Symptom overlap for malaria and pneumonia-policy implications for home management strategies. Acta Trop. 2004;90(2):211–4.CrossRefPubMed
42.
go back to reference Hummel PH. Incidence in Tanzania of CF antibody to Coxiella burnetii in sera from man, cattle, sheep, goats and game. Vet Rec. 1976;98(25):501–5.CrossRefPubMed Hummel PH. Incidence in Tanzania of CF antibody to Coxiella burnetii in sera from man, cattle, sheep, goats and game. Vet Rec. 1976;98(25):501–5.CrossRefPubMed
43.
go back to reference Abebe A. Prevalence of Q fever infection in the Addis Ababa abattoir. Ethiopian med J. 1990;28(3):119–22. Abebe A. Prevalence of Q fever infection in the Addis Ababa abattoir. Ethiopian med J. 1990;28(3):119–22.
44.
go back to reference Botros BA, Soliman AK, Salib AW, Olson J, Hibbs RG, Williams JC, et al. Coxiella burnetii antibody prevalences among human populations in north-east Africa determined by enzyme immunoassay. Am J Trop Med Hyg. 1995;98(3):173–8. Botros BA, Soliman AK, Salib AW, Olson J, Hibbs RG, Williams JC, et al. Coxiella burnetii antibody prevalences among human populations in north-east Africa determined by enzyme immunoassay. Am J Trop Med Hyg. 1995;98(3):173–8.
45.
go back to reference Nahed G, Abdel-moein A. Seroprevalence of Coxiella burnetii antibodies among farm animals and human contacts in Egypt. J Am Sci. 2012;8:619–21. Nahed G, Abdel-moein A. Seroprevalence of Coxiella burnetii antibodies among farm animals and human contacts in Egypt. J Am Sci. 2012;8:619–21.
46.
go back to reference Schelling E, Diguimbaye C, Daoud S, Nicolet J, Boerlin P, Tanner M, et al. Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad. Prev Vet Med. 2003;61(4):279–93.CrossRefPubMed Schelling E, Diguimbaye C, Daoud S, Nicolet J, Boerlin P, Tanner M, et al. Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad. Prev Vet Med. 2003;61(4):279–93.CrossRefPubMed
47.
go back to reference Gumi B, Firdessa R, Yamuah L, Sori T, Tolosa T, Aseffa A, et al. Seroprevalence of Brucellosis and Q-Fever in Southeast Ethiopian Pastoral Livestock. J Vet Sci Med Diagn. 2013; 2(1). doi:10.4172/2325-9590.1000109. Gumi B, Firdessa R, Yamuah L, Sori T, Tolosa T, Aseffa A, et al. Seroprevalence of Brucellosis and Q-Fever in Southeast Ethiopian Pastoral Livestock. J Vet Sci Med Diagn. 2013; 2(1). doi:10.​4172/​2325-9590.​1000109.
48.
go back to reference Hussien M, ElFahal A, Enan K, Taha K, Mohammed M, Salih D, et al. Seroprevalence of Q fever in Goats of the Sudan. Vet World. 2012;5:394–7.CrossRef Hussien M, ElFahal A, Enan K, Taha K, Mohammed M, Salih D, et al. Seroprevalence of Q fever in Goats of the Sudan. Vet World. 2012;5:394–7.CrossRef
49.
go back to reference Reinthaler FF, Mascher F, Sixl W, Arbesser CH. Incidence of Q fever among cattle, sheep and goats in the Upper Nile province in southern Sudan. Vet Rec. 1988;122(6):137.CrossRefPubMed Reinthaler FF, Mascher F, Sixl W, Arbesser CH. Incidence of Q fever among cattle, sheep and goats in the Upper Nile province in southern Sudan. Vet Rec. 1988;122(6):137.CrossRefPubMed
51.
go back to reference Jiang X, Baldwin CL. Effects of cytokines on intracellular growth of Brucella abortus. Infect Immun. 1993;61(1):124–34.PubMedPubMedCentral Jiang X, Baldwin CL. Effects of cytokines on intracellular growth of Brucella abortus. Infect Immun. 1993;61(1):124–34.PubMedPubMedCentral
52.
go back to reference Ascher MS, Berman MA, Ruppanner R. Initial clinical and immunologic evaluation of a new phase IQ fever vaccine and skin test in humans. J Infect Dis. 1983;148(2):214–22.CrossRefPubMed Ascher MS, Berman MA, Ruppanner R. Initial clinical and immunologic evaluation of a new phase IQ fever vaccine and skin test in humans. J Infect Dis. 1983;148(2):214–22.CrossRefPubMed
53.
go back to reference O’Neill T, Sargeant J, Poljak Z. The Effectiveness of Coxiella burnetii vaccines in occupationally exposed populations: a systematic review and meta‐Analysis. Zoonoses Public Hlth. 2014;61(2):81–96.CrossRef O’Neill T, Sargeant J, Poljak Z. The Effectiveness of Coxiella burnetii vaccines in occupationally exposed populations: a systematic review and meta‐Analysis. Zoonoses Public Hlth. 2014;61(2):81–96.CrossRef
Metadata
Title
Q fever is an old and neglected zoonotic disease in Kenya: a systematic review
Authors
J. Njeru
K. Henning
M. W. Pletz
R. Heller
H. Neubauer
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-2929-9

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