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.].
【在肯尼亚不同医院就诊的发热患者中，有耶尔森氏症，蜱传脑炎，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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病原体流行数据对于告知暴露和疾病风险至关重要。我们评估了蜱传脑炎 (TBE)，西尼罗河 (WN)，戊型肝炎病毒 (HEV)，克里米亚-刚果出血发热 (CCHF)，耶尔森氏病，莱姆病 (LD)，和布氏杆菌病在来自肯尼亚不同生态区的9个卫生保健机构的1033名急性发热性疾病患者中: 干旱和半干旱 (加里萨区医院、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、阿鲁佩区医院，kombewa县医院)，Kisii高地 (Kisii区医院) 和沿海 (Malindi区医院)。分析了患者的流行病学信息，例如地理，年龄，性别和饲养动物，作为潜在的危险因素。在1033样品中，619 (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。目前，最近和过去对病原体的集体血清阳性率为LD的9.4%，5.1% 和21.1%; WN的3.6%，0.5% 和12.4%; HEV的0.9%，0.5% 和16.9%; 布鲁氏菌病的5.8%，1.3% 和3.9%; 耶尔森氏菌病的5.7%，0.2% 和2.3%; 1.7%，TBE的0% 和6.2%; CCHF的0.4% 、0% 和1.9%。在Garissa地区医院 (优势比 [OR] = 3.41)，HEV (OR = 2.45) 和CCHF (OR = 5.46) 在Lodwar地区医院，LD在Alupe地区医院 (OR = 5.73)，kombewa分区医院 (or = 8.17) 和Malindi分区医院 (or = 3.3)。在较年轻的年龄组中，LD的暴露量最高，而耶尔森氏症则没有随年龄而变化。年龄是WN，布鲁氏菌病，CCHF，TBE和HEV的显着风险，在年龄> 14岁的人群中，WN (or = 2.30，p < 0.0001)，布鲁氏菌病 (or = 1.84，p = 0.005)，CCHF (or = 4.35，p = 0.001) 、TBE (or = 2.78，p < 0.0001) 、HEV (or = 1.94，p = 0.0001)。我们得出的结论是，LD普遍存在，对研究人群构成了沉重的健康负担，而耶尔森氏症和CCHF并不是重大威胁。展望未来，将需要基于社区的研究来捕获真实的血清阳性率和相关的风险因素。
