Cross-sectional study for determining the prevalence of Q fever in small ruminants and humans at El Minya Governorate, Egypt

Seroprevalence of Coxiella burnetii and potential tick vectors infesting domestic ruminants and community perception of the disease in pastoral areas of south Omo zone, southern Ethiopia

Background

Q fever is a worldwide occurring neglected zoonotic disease with great economic importance. The etiological agent, Coxiella burnetii, is a bacterium usually associated with subclinical infections in livestock, but may also cause reproductive pathology and spontaneous abortions in artiodactyl species including goats, sheep and cattle which are deemed to be the primary reservoirs of this disease.

Aims

The present cross-sectional and questionnaire survey was undertaken in three districts of the South Omo zone with the aims to comprehend the community perception of livestock keepers and professionals about the disease, estimate the seroprevalence of Coxiella burnetii (C. burnetii) in cattle and small ruminants and to determine the species of potential tick vectors of C. burnetii infesting cattle, sheep and goats.

Methods

A standard questionnaire was used to assess the community perception of livestock keepers and animal health professionals in the area about Q fever. Sera samples were collected from 1350 ruminants comprising 450 cattle, 450 goats and 450 sheep to detect C. burnetii antibodies using the ELISA technique. Furthermore, a total of 279 cattle, 197 goats and 73 sheep were examined for the presence of ticks, and overall, 2720 ticks were collected (1299 from cattle, 1020 from goats and 401 from sheep) and identified to the species level using morphologically identification keys.

Results

Findings of the study indicated that 43% of animal owners were aware of the main symptoms of the disease while the remaining 57% did not notice these symptoms in their animals. Additionally, majority of animal health professionals 76.2% in the area reported they were familiar with the causative agent of Q fever, while 23.8% expressed uncertainty regarding the cause of coxiellosis. An overall seroprevalence of C. burnetii of 37.6% in cattle (37.4% in female and 37.8% in male cattle) and 28.7% in small ruminants was recorded (which is significantly higher in goats than in sheep). The study indicated statistically significantly higher seroprevalence of C. burnetii (49.8%) in cattle infested with ticks than in those cattle free of ticks (24.2%), with three times higher seropositivity (OR = 2.97, p = 0.000) as compared to those cattle free of ticks (24.2%). Similarly, statistically significantly higher seroprevalence of C. burnetii was recorded in both sheep and goats infested with ticks (43.6%) as compared to those animals without ticks (22.9%), with the former being twice as likely to test seropositive (OR = 2.15, p = 0.000). A total of nine different tick species were identified, namely Amblyomma variegatum (Am. variegatum) with 26.3% (342; 217 males, 101 females and 24 nymphs), Amblyomma cohaerens (Am. cohaerens) with 47.96% (370 males, 253 females), Amblyomma gemma (Am. gemma) with 4.00% (52; 29 males, 23 female), Rhipicephalus pulchellus (Rh. pulchellus) with 10.6% (138; 87 males, 51 females), Rhipicephalus pravus (Rh. pravus) with 0.2% (3; 2 males, 1 females), Rhipicephalus evertsi (Rh. evertsi) with 4.7% (61; 39 males, 22 females), Rhipicephalus praetextatus (Rh. praetextatus) with 0.8% (10; 7 males, 3 females), Rhipicephalus decoloratus (Rh decoloratus) with 2.9% (38; 4 males, 34 females) and Hyalomma truncatum (Hy. truncatum) with 2.5% (32 females).

Conclusion

The present study highlighted the significance of Q fever in ruminants and compiled information about the community perception of livestock keepers and veterinary professionals of the study areas. The role of ruminants and their ticks in the epidemiology of C. burnetii requires further research using molecular tools to better understand appropriate method of intervention that will help to reduce negative impacts on the productivities of livestock and the health of humans in Ethiopia.

Seroprevalence of Q fever (Coxiella burnetii) in sheep in the Kwahu West municipality, Eastern Region, Ghana

Query fever, also known as Q fever, is a zoonotic disease caused by Coxiella burnetii. It is a cause of abortion in livestock and presents as a febrile illness in humans. A correlation between the incidence of the disease in humans and abortion in goats and sheep farms has been reported in countries such as the Netherlands and Australia. In Ghana, the occurrence of Q fever in both livestock and humans has not been fully explored. This study sought to determine the seroprevalence of Q fever in livestock in Nkawkaw, in the Eastern Region of Ghana. Sera obtained from 92 sheep from 12 farms were tested using the indirect multi-species ELISA for the detection of anti-Coxiella burnetii antibodies. Animal demographics, farms' proximity to human settlement and history of abortion in relation to the Q fever status were assessed. The overall prevalence of Q fever was 13.0 % [95 % CI 6.9-21.6] (12/92). Both sexes were equally affected, with a sex-specific prevalence of 13.0 % each. The farm-specific prevalence was 50 %. Abortions were reported on eight (8) of the 12 farms, and all farms were located less than 200 m from human habitation. Only proximity of farm to human settlement showed statistical significance. Q fever is prevalent in Nkawkaw and requires the attention of both animal and health authorities, using the One- Health approach to nip any future epidemics in its bud.

Acute Q fever in individuals with acute febrile illness & exposure to farm animals: Clinical manifestations & diagnostic approaches

Background & objectives Q fever is an important zoonotic disease affecting humans as well as animals. The objective of this study was to assess the burden of Q fever in individuals with acute febrile illness, particularly those in close contact with animals. Various diagnostic methods were also evaluated in addition to clinical examination analysis and associated risk factors. Methods Individuals presenting with acute febrile illness who had animal exposure were enrolled (n=92) in this study. Serum samples were tested using IgG and IgM phase 2 enzyme linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). The PCR targeting the com1 and IS1111 genes was performed on blood samples. PCR amplicons were sequenced and phylogenetically analysed. Demographic data, symptoms, and risk factors were collected through a structured questionnaire. Results Among individuals with acute febrile illness, 34.7 per cent (32 out of 92) were found to be infected with Coxiella burnetii. PCR exhibited the highest sensitivity among the diagnostic methods employed. The most common clinical manifestations included headache, chills, arthralgia, and fatigue. Individuals engaged in daily livestock-rearing activities were found to be at an increased risk of infection. Interpretation & conclusions Q fever is underdiagnosed due to its varied clinical presentations, diagnostic complexities, and lack of awareness. This study underscores the importance of regular screening for Q fever in individuals with acute febrile illness, particularly those with animal exposure. Early diagnosis and increased awareness among healthcare professionals are essential for the timely management and prevention of chronic complications associated with Q fever.

Molecular detection and diversity of tick-borne rickettsial pathogens in ticks collected from camel (Camelus dromedarius) in Upper Egypt

Tick-borne rickettsial pathogens pose significant threats to public and animal health. In Upper Egypt, limited information exists regarding the prevalence and diversity of such tick-borne pathogens. Therefore, this study aimed to conduct a comprehensive investigation to elucidate the presence and variety of tick-borne rickettsial pathogens in Upper Egyptian camels. Our results revealed a prevalence of 2.96 % for Anaplasma marginale and 0.34 % for Candidatus Anaplasma camelii among Hyalomma ticks. However, Ehrlichia spp. weren't detected in our study. The identification of Ca. A. camelii in H. dromedari ticks was documented for the first time, suggesting a potential mode of transmission in camels. Notably, this study marks the first documentation of Rickettsia aeschlimannii with a prevalence of 6.06 % in the study area. Furthermore, we detected Coxiella burnetii in a prevalence of 8.08 % in Hyalomma ticks, indicating a potential risk of Q fever transmission. Molecular techniques results were confirmed by sequencing and phylogenetic analysis and provided valuable insights into the epidemiology of these pathogens, revealing their diversity. This study is vital in understanding tick-borne rickettsial pathogens' prevalence, distribution, and transmission dynamics in Upper Egypt. In conclusion, our findings emphasize the importance of continued research to enhance our understanding of the epidemiology and impact of these pathogens on both animal and human populations.

Molecular and seroepidemiological investigation of Сoxiella burnetii and spotted fever group rickettsiae in the southern region of Kazakhstan

Ticks are involved in the circulation of a number of human pathogens, including spotted fever group (SFG) Rickettsia spp. and Coxiella burnetii. Little is known about the occurrence of these microorganisms in the southern region of Kazakhstan. In 2018-2022, a total of 726 ticks were collected from bitten humans, livestock, and vegetation in four oblasts of the southern region of Kazakhstan and subjected to DNA extraction. The overall infection rate of Coxiella spp. and Rickettsia spp. in the ticks was 3.3% (24/726) and 69.9% (300/429), respectively. Phylogenetic analysis of ompA and gltA genes revealed the presence of three pathogenic SFG rickettsiae: Candidatus R. tarasevichiae, R. aeschlimannii and R. raoultii in ticks collected from bitten humans. In addition, Candidatus R. barbariae was detected in six Rhipicephalus turanicus ticks for the first time in Kazakhstan. To determine the seroprevalence of C. burnetii infection, we performed a serological analysis of samples collected from 656 domestic ruminants (cattle, sheep, and goats) in the region. Overall, 23.5% (154/656) of the animals tested were positive for IgG against C. burnetii. Seroprevalence at the herd level was 54% (28/52). Goats (43%; 12/28; odds ratio (OD) = 28.9, p < 0.05) and sheep (31.9%; 137/430; OD = 18.1, p < 0.05) had higher seroprevalence than cattle (2.5%; 5/198). Among the risk factors considered in this study, age (p = 0.003) and the oblast in which the animals were sampled (p = 0.049) were statistically associated with seropostivity for Q fever in sheep, according to the results of multivariate logistic regression analysis. Seroprevalence ranged from 0% to 55.5% in animals in different districts of the southern region of Kazakhstan. Active C. burnetii bacteremia was detected in four of 154 (2.6%) seropositive animals. The data obtained provide strong evidence of the presence of pathogenic rickettsiae and C. burnetii in the southern region of Kazakhstan and emphasize the need to improve epidemiological surveillance in the region.

Serosurvey of selected reproductive pathogens in domestic ruminants from Upper Egypt

Toxoplasmosis, neosporosis, and Q fever are among the most important abortifacient diseases in ruminants worldwide. These diseases result in huge economic losses in livestock besides the fact that some of are of public health concern. The present study aimed to update the data about the current seroepidemiological situation of these diseases in Upper Egypt. A total of 411 blood samples were collected from small and large ruminants and serologically tested against the presence of T. gondii, N. caninum, and C. burnetii. Generalized estimating equation (GEE) models were performed to assess the potential risk factors associated with the exposure to these pathogens. The overall seroprevalence of T. gondii was 47.9% (197/411) with an individual seropositivity of 59.4% (63/106), 58.6% (17/29), 38.8% (54/139) and 46% (63/137) in cattle, buffalo, sheep and goats, respectively. Meanwhile, 9.7% (38/411) of the examined animals were tested positive for anti-N. caninum antibodies, with an individual seropositivity of 13.2% (12/106), 34.5% (10/29), 8.6% (12/139) and 2.9% (4/137) in cattle, buffalo, sheep and goats, respectively. Furthermore, the overall prevalence of antibodies against C. burnetii was 17.3% (63/411), and exposure to this pathogen was detected in 4.7% (5/106) of cattle, 19.3% (20/129) of sheep, 29.2% (38/130) of goats but none of the examined buffalo were found to be seropositive. A total of 12.1% (50/411) of the examined animals showed co-exposure to at least two of the tested pathogens. Regarding the potential risk factors, there were statistically significant differences among species in the frequency of exposure to the three tested pathogens. Age (> 6 months) was also shown to be a significant risk factor associated with T. gondii exposure. The results obtained provided updated information about the occurrence of three of the main reproductive pathogens in Upper Egypt. The high seropositivity values found for the tested zoonotic pathogens in most of the analyzed ruminant species suggest the necessity of performing additional in-depth studies to evaluate the epidemiology of these pathogens in the study area.

Human-biting ticks and zoonotic tick-borne pathogens in North Africa: diversity, distribution, and trans-Mediterranean public health challenges

North Africa is home to more than 200 million people living across five developing economies (Egypt, Libya, Tunisia, Algeria, and Morocco) and two Spanish exclaves (Ceuta and Melilla), many of whom are impacted by ticks and tick-borne zoonoses. Populations in Europe are also increasingly vulnerable to North African ticks and tick-borne zoonoses due to a combination of climate change and the movement of ticks across the Mediterranean on migratory birds, human travellers, and trafficked wildlife. The human-biting ticks and tick-borne zoonoses in North Africa are reviewed along with their distribution in the region. We also assess present and future challenges associated with ticks and tick-borne zoonoses in North African and highlight opportunities for collaboration and coordination between governments in Europe and North Africa to address public health challenges posed by North African ticks and tick-borne zoonoses.

Tick-borne diseases in Egypt: A one health perspective

Background

Ticks are important arthropod vectors that transmit pathogens to humans and animals. Owing to favourable climatic and environmental conditions, along with animal importation from neighbouring countries, ticks and tick-borne diseases (TBDs) are widespread in Egyptian localities. Here, we review the current knowledge on the epidemiology of TBDs in Egypt in light of the One Health paradigm.

Methods and results

Five scientific databases, including "Web of Science", "Scopus", "PubMed", "Science Direct", and "Google Scholar", were searched for articles describing TBDs in Egypt. A total of 18 TBDs have been reported in humans and animals, including three protozoal diseases (babesiosis, theileriosis, and hepatozoonosis), 12 bacterial diseases (anaplasmosis, ehrlichiosis, Lyme borreliosis, bovine borreliosis, tick-borne relapsing fever, Mediterranean spotted fever, African tick-borne fever, lymphangitis-associated rickettsiosis, bartonellosis, tularaemia, Q fever, and aegyptianellosis), and three viral diseases (Crimean-Congo haemorrhagic fever, Alkhurma haemorrhagic fever, and Lumpy skin disease).

Conclusions

Despite the circulation of zoonotic tick-borne pathogens among livestock and tick vectors, human infections have been overlooked and are potentially limited to infer the actual communicable disease burden. Therefore, facility-based surveillance of TBDs, combined with capacity building for laboratory diagnostics in healthcare facilities, is urgently required to improve diagnosis and inform policy-making in disease prevention. Additionally, collaboration between expert researchers from various disciplines (physicians, biologists, acarologists, and veterinarians) is required to develop advanced research projects to control ticks and TBDs. Considering that domestic livestock is integral to many Egyptian households, comprehensive epidemiological studies on TBDs should assess all disease contributors, including vertebrate hosts (animals, humans, and rodents) and ticks in the same ecological region, for better assessment of disease burden. Additionally, upscaling of border inspections of imported animals is required to stop crossover movements of ticks and TBDs.

The First Report of Coxiella burnetii as a Potential Neglected Pathogen of Acute Hepatitis of Unknown Causes in Egypt

The World Health Organization (WHO) recently alerted the emergence of new pathogens causing acute hepatitis in children across several countries. This new situation directs us to the screening of neglected pathogens that cause acute hepatitis. Q-fever is a zoonotic disease, caused by Coxiella burnetii. Although a high seroprevalence of Coxiella burnetii was recorded in animals present in Egypt, Q-fever is still a neglected disease, and the diagnosis of Q-fever is not routinely performed in Egyptian hospitals. In this study, we performed a retrospective assessment for Coxiella burnetii in cases of hepatitis of unknown causes (HUC) enrolled in Assiut University hospitals, in Egypt. Out of 64 samples of HUC, 54 samples were negative for all hepatitis markers, labeled as acute hepatitis of unknown etiology (AHUE), and 10 samples tested positive for adenovirus and Hepatitis E virus (HEV). Q-fever was detected in 3 out of 54 (5.6%) of AHUE, and one sample was confirmed as coinfection of HEV/Q-fever. Jaundice was the most common clinical symptom developed in the patients. In conclusion, Coxiella burnetii was found to be a potential cause of acute hepatitis in HUC. The diagnosis of Q-fever should be considered in acute hepatitis cases in Egyptian hospitals.

Endemicity of Coxiella burnetii infection among people and their livestock in pastoral communities in northern Kenya

Background

Coxiella burnetti can be transmitted to humans primarily through inhaling contaminated droplets released from infected animals or consumption of contaminated dairy products. Despite its zoonotic nature and the close association pastoralist communities have with their livestock, studies reporting simultaneous assessment of C. burnetti exposure and risk-factors among people and their livestock are scarce.

Objective

This study therefore estimated the seroprevalence of Q-fever and associated risk factors of exposure in people and their livestock.

Materials and methods

We conducted a cross-sectional study in pastoralist communities in Marsabit County in northern Kenya. A total of 1,074 women and 225 children were enrolled and provided blood samples for Q-fever testing. Additionally, 1,876 goats, 322 sheep and 189 camels from the same households were sampled. A structured questionnaire was administered to collect individual- and household/herd-level data. Indirect IgG ELISA kits were used to test the samples.

Results

Household-level seropositivity was 13.2% [95% CI: 11.2–15.3]; differences in seropositivity levels among women and children were statistically insignificant (p = 0.8531). Lactating women had higher odds of exposure, odds ratio (OR) = 2.4 [1.3–5.3], while the odds of exposure among children increased with age OR = 1.1 [1.0–1.1]. Herd-level seroprevalence was 83.7% [81.7–85.6]. Seropositivity among goats was 74.7% [72.7–76.7], while that among sheep and camels was 56.8% [51.2–62.3] and 38.6% [31.6–45.9], respectively. Goats and sheep had a higher risk of exposure OR = 5.4 [3.7–7.3] and 2.6 [1.8–3.4], respectively relative to camels. There was no statistically significant association between Q-fever seropositivity and nutrition status in women, p = 0.900 and children, p = 1.000. We found no significant association between exposure in people and their livestock at household level (p = 0.724) despite high animal exposure levels, suggesting that Q-fever exposure in humans may be occurring at a scale larger than households.

Conclusion

The one health approach used in this study revealed that Q-fever is endemic in this setting. Longitudinal studies of Q-fever burden and risk factors simultaneously assessed in human and animal populations as well as the socioeconomic impacts of the disease and further explore the role of environmental factors in Q-fever epidemiology are required. Such evidence may form the basis for designing Q-fever prevention and control strategies.

Pathological study and molecular detection of zoonotic diseases in small ruminants at slaughter houses in Mymensingh, Bangladesh

Background and Aim:

Slaughterhouses act as a significant public health hotspot in developing countries like Bangladesh. The study aimed to investigate small ruminants at slaughterhouses for pathological study and molecular detection of important zoonotic diseases.

Materials and Methods:

A total of 75 goats and 14 sheep were investigated from June 2019 to January 2020 at different slaughterhouses in Mymensingh division, Bangladesh. The targeted diseases were tuberculosis (TB), listeriosis, Q fever, brucellosis, anthrax, toxoplasmosis, hydatidosis, and linguatulosis. The tentative diagnosis was made based on gross and histopathological lesions. Polymerase chain reaction (PCR) was performed to confirm the causal agents of zoonotic diseases using disease-specific primers.

Results:

Grossly, caseous nodule formation in the visceral organs; enlarged and calcifications of mesenteric lymph nodes (MLNs); hydatid cyst formation in the liver were the predominant lesions observed. Histopathologically, granuloma, caseous necrosis, and calcifications admixed with acid-fast bacteria in the MLNs, liver, spleen, and kidney were seen as suggestive of infectivity due to TB. Septic lymphadenitis mixed with rod-shaped bacteria, doughnut granuloma, fibroplasia accompanied by eosinophils and lymphocytic infiltration in MLNs, and portal granuloma were observed in listeriosis, Q fever, linguatulosis, and toxoplasmosis suspected cases, respectively. The PCR amplified Mycobacterium tuberculosis complex (372 bp), Mycobacterium bovis (600 bp), Listeria monocytogenes (517 bp), Toxoplasma gondii (512 bp), and Coxiella burnetii (687 bp) species-specific amplicons. In addition, linguatulosis and hydatidosis were identified in six and three goats, respectively. Brucellosis and anthrax were not detected in any cases. The slaughterhouse samples were also found to harbor the coexistence of different zoonotic pathogens.

Conclusion:

Deadly infectious zoonotic diseases in goats and sheep at slaughterhouses may cause widespread public health risks. As a result, more intensive monitoring and epidemiological surveys are required to successfully prevent and control zoonotic diseases.

Molecular Epidemiology and Species Diversity of Tick-Borne Pathogens of Animals in Egypt: A Systematic Review and Meta-Analysis

Ticks and tick-borne pathogens (TTBPs) are listed among the most serious concerns harming Egyptian livestock’s productivity. Several reports on tick-borne pathogens (TBPs) from various geographical regions in the country were published. However, data on the molecular characterization of TBPs are the most beneficial for understanding the epidemiology of this important group of pathogens. In this study, we present the first meta-analysis on the molecular epidemiology and species diversity of TBPs infecting animals in Egypt. All published studies on TBPs were systematically collected from various databases (PubMed, Scopus, ScienceDirect, the Egyptian Knowledge Bank, and Google Scholar). Data from eligible papers were extracted and subjected to various analyses. Seventy-eight studies were found to be eligible for inclusion. Furthermore, ticks infesting animals that were molecularly screened for their associated pathogens were also included in this study to display high species diversity and underline the high infection risk to animals. Theileria annulata was used as parasite model of TBPs to study the genetic diversity and transmission dynamics across different governorates of Egypt. This study extends cross-comparisons between all published molecular data on TBPs in Egypt and provides resources from Egyptian data in order to better understand parasite epidemiology, species diversity, and disease outcome as well as the development and implementation of prevention and control methods for public health, veterinary care practitioners, and animal owners all over the country.

Serological Prevalence of and Risk Factors for Coxiella burnetti Infection in Women of Punjab Province, Pakistan

Background: Coxiella burnetii, the etiological agent of Q (query) fever, provokes abortions in ruminants and is suspected to cause adverse pregnancy outcomes in women. Infection of pregnant women is linked with high mortality and morbidity of the fetus and the mother is at high risk to acquire chronic Q fever. This research was conducted to evaluate the prevalence of Q fever in women and to detect associated risk factors in four districts of Punjab Province, Pakistan. Methods: A total of 297 blood samples were obtained from 147 pregnant and 150 non-pregnant women of the districts Okara, Jhang, Chiniot and Faisalabad of Punjab, Pakistan. Data related to risk factors and demographic parameters were collected using a questionnaire. Serum samples were screened for phase I and phase II specific IgG antibodies for antigens of phase I and phase II using ELISA tests. Univariate and binary regression were used to analyze important risk factors of Q fever. Results: Twenty-five serum samples (8.4%) were found seropositive for Q fever. Seventeen women were positive for Phase-I and twenty-one were positive for phase-II antibodies. Highest and statistically significant (p < 0.05) seroprevalence of 17.1% was observed in Faisalabad. Age, urbanicity, living status, pregnancy status, abortion history, occupation, and consumption of tap water were positively correlated (p < 0.05) with Q fever, while being aged, urbanity, low income, contact with animals and consumption of tap water was identified as potential risk factors. Conclusions: Q fever is prevalent in women of Pakistan. There is a need for an awareness program about the importance of C. burnetii infections and prevention strategies in women during pregnancy to minimize adverse pregnancy outcomes.

Sero-epidemiological survey of Coxiella burnetii in livestock and humans in Tana River and Garissa counties in Kenya

Background

Coxiella burnetii is a widely distributed pathogen, but data on its epidemiology in livestock, and human populations remain scanty, especially in developing countries such as Kenya. We used the One Health approach to estimate the seroprevalance of C. burnetii in cattle, sheep, goats and human populations in Tana River county, and in humans in Garissa county, Kenya. We also identified potential determinants of exposure among these hosts.

Methods

Data were collected through a cross-sectional study. Serum samples were taken from 2,727 animals (466 cattle, 1,333 goats, and 928 sheep) and 974 humans and screened for Phase I/II IgG antibodies against C. burnetii using enzyme-linked immunosorbent assay (ELISA). Data on potential factors associated with animal and human exposure were collected using a structured questionnaire. Multivariable analyses were performed with households as a random effect to adjust for the within-household correlation of C. burnetii exposure among animals and humans, respectively.

Results

The overall apparent seroprevalence estimates of C. burnetii in livestock and humans were 12.80% (95% confidence interval [CI]: 11.57–14.11) and 24.44% (95% CI: 21.77–27.26), respectively. In livestock, the seroprevalence differed significantly by species (p < 0.01). The highest seroprevalence estimates were observed in goats (15.22%, 95% CI: 13.34-17.27) and sheep (14.22%, 95% CI: 12.04–16.64) while cattle (3.00%, 95% CI: 1.65–4.99) had the lowest seroprevalence. Herd-level seropositivity of C. burnetii in livestock was not positively associated with human exposure. Multivariable results showed that female animals had higher odds of seropositivity for C. burnetii than males, while for animal age groups, adult animals had higher odds of seropositivity than calves, kids or lambs. For livestock species, both sheep and goats had significantly higher odds of seropositivity than cattle. In human populations, men had a significantly higher odds of testing positive for C. burnetii than women.

Conclusions

This study provides evidence of livestock and human exposure to C. burnetii which could have serious economic implications on livestock production and impact on human health. These results also highlight the need to establish active surveillance in the study area to reduce the disease burden associated with this pathogen.

Q fever caused by Coxiella burnetii is a significant zoonotic disease that affects wildlife, domestic animals and humans. This study determined the prevalence of antibodies to C. burnetii in livestock (cattle, sheep, and goats) and human populations in arid and semi-arid areas of Kenya between December 2013 and February 2014. We also identified potential factors that were associated with exposure among the above-targeted hosts. Results from this study showed considerable exposure in both livestock and human populations. However, human exposure to this pathogen at the household level was not correlated with herd-level seropositivity. Further studies are needed to elucidate the transmission routes of this pathogen among humans.

A Review on Important Zoonotic Bacterial Tick-Borne Diseases in the Eastern Mediterranean Region

Background

Zoonotic diseases as health concerns worldwide account for more than half of the emerging infectious diseases. Arachnids are powerful vectors to transmit several diseases to humans. Additionally, these emerging zoonotic diseases have been a considerable health threat in the Eastern Mediterranean Region of the WHO (EMRO) due to the large population living close to farms and international trade with nearby countries.

Methods

This review study is based on the reported three tick-borne diseases, Lyme disease, Tularemia, and Q fever, from Iran and other EMRO countries. To this end, we searched PubMed central, ISI web of Science, and Google with the related keywords in English at any time. The reported data are then sorted by countries for each disease.

Results

According to the published data, 15 countries in the region have one/more emerging infectious diseases. Q fever has been the most frequent infection in EMRO countries, while Lyme was less recorded. Furthermore, Iran is among the countries with documented history of all three investigated diseases.

Conclusion

Tick-borne disease is popular among EMRO countries, indicating that they have natural conditions for infections in animals and humans. It appears necessary to develop a disease management strategy and control programs against tick-borne diseases (TBDs). Moreover, the disease-resistant animal could be bred instead of susceptible livestock. Therefore, research studies to control TBDs should be regarded as a top priority plan.

Coxiella burnetii in Dromedary Camels (Camelus dromedarius): A Possible Threat for Humans and Livestock in North Africa and the Near and Middle East?

The "One Health" concept recognizes that human health is connected to animal health and to the ecosystems. Coxiella burnetii-induced human Q fever is one of the most widespread neglected zoonosis. The main animal reservoirs responsible for C. burnetii transmission to humans are domesticated ruminants, primarily goats, sheep, and cattle. Although studies are still too sparse to draw definitive conclusions, the most recent C. burnetii serosurvey studies conducted in herds and farms in Africa, North Africa, Arabian Peninsula, and Asia highlighted that seroprevalence was strikingly higher in dromedary camels (Camelus dromedarius) than in other ruminants. The C. burnetii seroprevalence in camel herds can reach more than 60% in Egypt, Saudi Arabia, and Sudan, and 70 to 80% in Algeria and Chad, respectively. The highest seroprevalence was in female camels with a previous history of abortion. Moreover, C. burnetii infection was reported in ticks of the Hyalomma dromedarii and Hyalomma impeltatum species collected on camels. Even if dromedary camels represent <3% of the domesticated ruminants in the countries of the Mediterranean basin Southern coast, these animals play a major socioeconomic role for millions of people who live in the arid zones of Africa, Middle East, and Asia. In Chad and Somalia, camels account for about 7 and 21% of domesticated ruminants, respectively. To meet the growing consumers demand of camel meat and milk (>5 million tons/year of both raw and pasteurized milk according to the Food and Agriculture Organization) sustained by a rapid increase of population (growth rate: 2.26-3.76 per year in North Africa), dromedary camel breeding tends to increase from the Maghreb to the Arabic countries. Because of possible long-term persistence of C. burnetii in camel hump adipocytes, this pathogen could represent a threat for herds and breeding farms and ultimately for public health. Because this review highlights a hyperendemia of C. burnetii in dromedary camels, a proper screening of herds and breeding farms for C. burnetii is urgently needed in countries where camel breeding is on the rise. Moreover, the risk of C. burnetii transmission from camel to human should be further evaluated.

Toxoplasma gondii seropositivity and the associated risk factors in sheep and pregnant women in El-Minya Governorate, Egypt

BACKGROUND AND AIM

The cosmopolite protozoan, Toxoplasma gondii, has a significant economic and medical impact. Cats traditionally play a predominant role in the disease maintenance cycle; however, humans can be infected as a result of milk and meat consumption of Toxoplasma-infected livestock. In addition, infected pregnant women, even symptomless, can pass the disease to their unborn fetus. The limited clinical records and absence of specific national educational programs in countries like Egypt underscore the need for periodic toxoplasmosis disease evaluation. Here, we identified T. gondii seroprevalence among sheep and pregnant women and the associated risk factors in El-Minya Governorate, Egypt.

MATERIALS AND METHODS

Using peripheral blood, we detected T. gondii-specific antibodies in 151 sheep and 96 pregnant women sera from El-Minya Governorate using latex agglutination and indirect enzyme-linked immunosorbent assay. The impact of different environmental and behavioral risk factors identified with in-person interviews and serology results on acquiring toxoplasmosis was statistically analyzed.

RESULTS

The overall toxoplasmosis seroprevalence was 39.1% and 22.9% in sheep and pregnant women, respectively. Significantly higher seroprevalence was correlated with increasing sheep age and geographical location. Nonetheless, no statistical significance was found based on abortion history and pregnancy status of the examined sheep. Exposure factors important for pregnant women included pregnancy trimester, contact with cats, and the habit of eating undercooked sheep meat, which all had a statistically significant association with Toxoplasma seropositivity.

CONCLUSION

The current study confirms increased antibodies against toxoplasmosis in both sheep and pregnant women in El-Minya Governorate and a clear association between women's age, contact with cats, and the habit of eating undercooked sheep meat and seroreactivity to T. gondii. These results strongly suggest the need for a more comprehensive epidemiological study and public health awareness education for toxoplasmosis.

Serological and Molecular Investigation of Coxiella burnetii in Small Ruminants and Ticks in Punjab, Pakistan

Coxiellosis is a zoonotic disease caused by the obligate intracellular bacterium Coxiella burnetii affecting the productive and reproductive capabilities of animals. This study was conducted to gain insight into the seroprevalence of coxiellosis in small ruminants in seven farms of the Punjab, Pakistan. Potential risk factors were assessed. In total, 1000 serum samples (500 from sheep and 500 from goats) and 163 ticks were collected from the ruminants. All these 163 ticks were merged into 55 pools (29 pools for ticks from sheep and 26 pools for ticks from goat). Serum samples were investigated using an indirect ELISA and PCR. Coxiella burnetii DNA was detected in 29 pooled seropositive samples and 11 pooled ticks by real-time qPCR. Serological analysis revealed a prevalence of 15.6% and 15.0% in sheep and goats, respectively. A significant association was found between seropositivity and different variables like district, lactational status, reproductive status, body condition and reproductive disorders. Univariate analysis showed that detection of C. burnetii DNA in tick pools was significantly associated with the presence of ticks on sheep and goats. However, a non-significant association was found for the prevalence of C. burnetii DNA in serum pools. Hence, C. burnetii infection is prevalent in small ruminants and ticks maintained at livestock farms in Punjab, Pakistan.

Systematic Review of Important Bacterial Zoonoses in Africa in the Last Decade in Light of the 'One Health' Concept

Zoonoses present a major public health threat and are estimated to account for a substantial part of the infectious disease burden in low-income countries. The severity of zoonotic diseases is compounded by factors such as poverty, living in close contact with livestock and wildlife, immunosuppression as well as coinfection with other diseases. The interconnections between humans, animals and the environment are essential to understand the spread and subsequent containment of zoonoses. We searched three scientific databases for articles relevant to the epidemiology of bacterial zoonoses/zoonotic bacterial pathogens, including disease prevalence and control measures in humans and multiple animal species, in various African countries within the period from 2008 to 2018. The review identified 1966 articles, of which 58 studies in 29 countries met the quality criteria for data extraction. The prevalence of brucellosis, leptospirosis, Q fever ranged from 0–40%, 1.1–24% and 0.9–28.2%, respectively, depending on geographical location and even higher in suspected outbreak cases. Risk factors for human zoonotic infection included exposure to livestock and animal slaughters. Dietary factors linked with seropositivity were found to include consumption of raw milk and locally fermented milk products. It was found that zoonoses such as leptospirosis, brucellosis, Q fever and rickettsiosis among others are frequently under/misdiagnosed in febrile patients seeking treatment at healthcare centres, leading to overdiagnoses of more familiar febrile conditions such as malaria and typhoid fever. The interactions at the human–animal interface contribute substantially to zoonotic infections. Seroprevalence of the various zoonoses varies by geographic location and species. There is a need to build laboratory capacity and effective surveillance processes for timely and effective detection and control of zoonoses in Africa. A multifaceted ‘One Health’ approach to tackle zoonoses is critical in the fight against zoonotic diseases. The impacts of zoonoses include: (1) Humans are always in contact with animals including livestock and zoonoses are causing serious life-threatening infections in humans. Almost 75% of the recent major global disease outbreaks have a zoonotic origin. (2) Zoonoses are a global health challenge represented either by well-known or newly emerging zoonotic diseases. (3) Zoonoses are caused by all-known cellular (bacteria, fungi and parasites) and noncellular (viruses or prions) pathogens. (4) There are limited data on zoonotic diseases from Africa. The fact that human health and animal health are inextricably linked, global coordinated and well-established interdisciplinary research efforts are essential to successfully fight and reduce the health burden due to zoonoses. This critically requires integrated data from both humans and animals on zoonotic diseases.

Comprehensive literature review of the sources of infection and transmission routes of Coxiella burnetii, with particular regard to the criteria of "evidence-based medicine"

The present review aims to compile the currently available literature since 1936 according the sources of infection of the Q fever pathogen (Coxiella (C.) burnetii) as well as the transmission from animal to man and also from human to human. In terms of quality and validity, the existing publications were reviewed systematically. For this purpose, firstly a structured literature search was carried out using various databases and search engines supplemented by a manual literature search. For critical appraisal, 1444 relevant publications were identified for the moment and evaluated. A total of 73 publications describing a transmission of C. burnetii from animals to man or a human-to-human transmission were discovered. The identified publications are 29 case series, two case reports, 21 cohort studies and 21 case-control studies. With regard to the sources of infection, 25 publications describing the transmission of C. burnetii from sheep to humans could be identified.