Data on pathogen prevalence is crucial for informing exposure and disease risk. We evaluated serological evidence of tick-borne encephalitis (TBE), West Nile (WN), Hepatitis E virus (HEV), Crimean-Congo Hemorrhagic Fever (CCHF), Yersiniosis, Lyme Disease (LD), and brucellosis in 1033 patients presenting with acute febrile illness at 9 health care facilities from diverse ecological zones of Kenya: arid and semiarid (Garissa District Hospital, Lodwar District Hospital, Marigat District Hospital, Gilgil District Hospital), Lake Victoria basin (Kisumu District Hospital, Alupe District Hospital, Kombewa Sub-County Hospital), Kisii highland (Kisii District Hospital), and coastal (Malindi District Hospital). Epidemiological information of the patients such as geography, age, gender, and keeping animals were analyzed as potential risk factors. Of the 1033 samples, 619 (59.9%) were seropositive to at least one pathogen by IgM (current exposure), IgG/IgM (recent exposure), and IgG (past exposure). Collective seroprevalence for current, recent, and past to the pathogens was 9.4%, 5.1%, and 21.1% for LD; 3.6%, 0.5%, and 12.4% for WN; 0.9%, 0.5%, and 16.9% for HEV; 5.8%, 1.3%, and 3.9% for brucellosis; 5.7%, 0.2%, and 2.3% for yersiniosis; 1.7%, 0%, and 6.2% for TBE; and 0.4%, 0%, and 1.9% for CCHF. Brucellosis risk was higher in patients recruited at Garissa District Hospital (odds ratio [OR] = 3.41), HEV (OR = 2.45) and CCHF (OR = 5.46) in Lodwar District Hospital, LD in Alupe District Hospital (OR = 5.73), Kombewa Sub-district hospital (OR = 8.17), and Malindi District hospital (OR = 3.3). Exposure to LD was highest in the younger age group, whereas yersiniosis did not vary with age. Age was a significant risk for WN, brucellosis, CCHF, TBE, and HEV and in those aged >14 years there was an increased risk to WN (OR = 2.30, p < 0.0001), brucellosis (OR = 1.84, p = 0.005), CCHF (OR = 4.35, p = 0.001), TBE (OR = 2.78, p < 0.0001), and HEV (OR = 1.94, p = 0.0001). We conclude that LD is pervasive and constitutes a significant health burden to the study population, whereas yersiniosis and CCHF are not significant threats. Going forward, community-based studies will be needed to capture the true seroprevalence rates and the associated risk factors.
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【Serological Evidence of Yersiniosis, Tick-Borne Encephalitis, West Nile, Hepatitis E, Crimean-Congo Hemorrhagic Fever, Lyme Borreliosis, and Brucellosis in Febrile Patients Presenting at Diverse Hospitals in Kenya.].
【在肯尼亚各医院就诊的高热患者中的耶尔森病、,虫脑炎，西尼罗河，戊型肝炎，克里米亚-刚果出血热，莱姆病和布鲁氏菌病的血清学证据。】
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DOI：10.1089/vbz.2019.2484文章类型：杂志文章
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：有关病原体流行率的数据对于告知暴露和疾病风险至关重要。我们评估了1033例表现为tick传性脑炎（TBE），西尼罗河（WN），戊型肝炎病毒（HEV），克里米亚-刚果出血热（CCHF），耶尔森病，莱姆病（LD）和布鲁氏菌病的血清学证据来自肯尼亚不同生态区的9个医疗机构的急性发热性疾病：干旱和半干旱（加里萨斯区医院，罗德瓦尔区医院，马里加特区医院，吉尔吉尔区医院），维多利亚湖盆地（基苏木区医院，阿卢佩区医院，科姆贝瓦苏维埃-县医院），Kisii高地（Kisii地区医院）和沿海地区（马林迪地区医院）。分析患者的流行病学信息，例如地理，年龄，性别和饲养动物等，作为潜在的危险因素。在1033个样本中，有619个（59.9％）通过IgM（当前暴露），IgG / IgM（最近暴露）和IgG（过去暴露）对至少一种病原体呈血清阳性。 LD的当前，最近和过去的集体血清阳性率为LD的9.4％，5.1％和21.1％； WN为3.6％，0.5％和12.4％； HEV的0.9％，0.5％和16.9％；布氏杆菌病分别为5.8％，1.3％和3.9％；耶尔氏菌病分别为5.7％，0.2％和2.3％； TBE为1.7％，0％和6.2％； CCHF分别为0.4％，0％和1.9％。在Garissa地区医院招募的布鲁氏菌病风险较高（赔率[OR] = 3.41），在Lodwar District Hospital中的HEV（OR = 2.45）和CCHF（OR = 5.46），在Alupe地区医院的LD（OR = 5.73）， Kombewa街道医院（OR = 8.17）和马林迪区医院（OR = 3.3）。 LD暴露在年轻人群中最高，而耶尔森菌病并没有随年龄而变化。年龄是WN，布鲁氏菌病，CCHF，TBE和HEV的重大风险，而年龄大于14岁的人群中WN（OR = 2.30，p <0.0001），布鲁氏菌病（OR = 1.84，p = 0.005）的风险增加。 ，CCHF（OR ＝ 4.35，p ＝ 0.001），TBE（OR ＝ 2.78，p ＜0.0001）和HEV（OR ＝ 1.94，p ＝ 0.0001）。我们得出的结论是，LD无处不在，对研究人群构成重大的健康负担，而耶尔氏菌病和CCHF则不是重大威胁。展望未来，将需要进行基于社区的研究，以获取真实的血清阳性率和相关的危险因素。
