Abstract
BackgroundThe role of pathogen-mediated febrile illness in sub-Saharan Africa is receiving more attention, especially in Southern Africa where four countries (including Namibia) are actively working to eliminate malaria. With a high concentration of livestock and high rates of companion animal ownership, the influence of zoonotic bacterial diseases as causes of febrile illness in Namibia remains unknown.Methodology/Principal FindingsThe aim of the study was to evaluate exposure to Coxiella burnetii, spotted fever and typhus group rickettsiae, and Bartonella henselae using IFA and ELISA (IgG) in serum collected from 319 volunteer blood donors identified by the Blood Transfusion Service of Namibia (NAMBTS). Serum samples were linked to a basic questionnaire to identify possible risk factors. The majority of the participants (64.8%) had extensive exposure to rural areas or farms. Results indicated a C. burnetii prevalence of 26.1% (screening titre 1∶16), and prevalence rates of 11.9% and 14.9% (screening titre 1∶100) for spotted fever group and typhus group rickettsiae, respectively. There was a significant spatial association between C. burnetii exposure and place of residence in southern Namibia (P<0.021). Donors with occupations involving animals (P>0.012), especially cattle (P>0.006), were also significantly associated with C. burnetii exposure. Males were significantly more likely than females to have been exposed to spotted fever (P<0.013) and typhus (P<0.011) group rickettsiae. Three (2.9%) samples were positive for B. henselae possibly indicating low levels of exposure to a pathogen never reported in Namibia.Conclusions/SignificanceThese results indicate that Namibians are exposed to pathogenic fever-causing bacteria, most of which have flea or tick vectors/reservoirs. The epidemiology of febrile illnesses in Namibia needs further evaluation in order to develop comprehensive local diagnostic and treatment algorithms.
Highlights
Conclusions/Significance: These results indicate that Namibians are exposed to pathogenic fever-causing bacteria, most of which have flea or tick vectors/reservoirs
As developing countries work to eliminate malaria, it is imperative to describe which pathogens are responsible for febrile illnesses that have historically been misdiagnosed as malaria [1]
Pathogenic bacteria, notably C. burnetii, Bartonella henselae, as well as, spotted fever and typhus group rickettsiae were highlighted as potentially posing the greatest risk to animal and human health [11]
Summary
As developing countries work to eliminate malaria, it is imperative to describe which pathogens are responsible for febrile illnesses that have historically been misdiagnosed as malaria [1]. In the Moshi area of Tanzania, arboviruses (chikungunya and dengue [2]), bacteria (Coxiella burnetii, spotted fever and typhus group rickettsiae) [3] and other zoonotic pathogens (leptospirosis [4], histoplasmosis [5], and brucellosis [6]) were identified as the causes of fever in patients Studies like these are critical to support the development of diagnostic algorithms to account for other local causes of fever as malaria is eliminated [1,7]. Pathogenic bacteria, notably C. burnetii, Bartonella henselae, as well as, spotted fever and typhus group rickettsiae were highlighted as potentially posing the greatest risk to animal and human health [11] These zoonotic bacteria have been increasingly noted throughout sub-Saharan Africa, and there is a need to focus on their epidemiology [12,13,14]. With a high concentration of livestock and high rates of companion animal ownership, the influence of zoonotic bacterial diseases as causes of febrile illness in Namibia remains unknown
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