Q fever is an old and neglected zoonotic disease in Kenya: a systematic review.
Q fever is an old and neglected zoonotic disease in Kenya: a systematic review.
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DOI：
10.1186/s12889-016-2929-9
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发表时间：
2016-04-05
影响因子：
4.5
通讯作者：
Neubauer H
中科院分区：
文献类型：
--
作者：
Njeru J;Henning K;Pletz MW;Heller R;Neubauer H
Q热是一种被忽视的人畜共患病，由伯纳氏克希菌引起。对肯尼亚Q热流行病学的了解有限，没有注意控制和预防规划。本综述的目的是了解过去60年来肯尼亚人类和动物群体中Q热的情况，并帮助确定该国未来的研究重点。数据库检索了有关Q热的国内和国际科学研究或报告。我们纳入了1950年至2015年间发表的关于肯尼亚Q热流行、发病率和感染控制项目的研究和报告。提取有关科希氏菌感染流行率、研究设计、研究区域、研究人群的研究数据，并按研究年份进行分类。我们确定了15项符合数据提取条件的研究和报告。人类血清流行率研究显示，在进行调查的所有地区，伯纳蒂胞杆菌感染率在3%至35.8%之间，并发生了两次Q热暴发。牛的伯纳氏杆菌感染率为7.4 - 51.1%，绵羊为6.7 - 20%，骆驼为20 - 46%，山羊为20 - 46%，不同的生态区域和研究年份存在差异。农业和缺乏防护服与人类血清阳性增加有关。然而，缺乏关于Q热意识、影响伯纳蒂杆菌感染的潜在文化经济因素，以及在经济和生态不同的肯尼亚地区，病原体循环如何嵌入牲畜生产和管理系统的高质量数据。我们没有发现关于国家疾病发病率估计或疾病监测和控制工作的研究。伯纳蒂克希菌感染在人类和广泛的动物种群中很常见，但仍未被认识和低估，因此对肯尼亚的人类和动物健康构成重大威胁。影响病原体传播、持续和传播的因素尚不清楚。肯尼亚需要综合疾病监测和预防/控制规划。
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. 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. 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. 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.