Abstract
Diseases of zoonotic origin contribute to the burden of febrile illnesses in developing countries. We evaluated serologic evidence of exposure to Bacillus anthracis, Brucella spp., spotted fever group rickettsioses (SFGR), and typhus group rickettsioses (TGR) from samples of persons aged 15–64 years collected during a nationwide human immunodeficiency virus (HIV) serosurvey conducted in 2007 in Kenya. The seropositivity observed for pathogens was B. anthracis 11.3%, Brucella spp. 3.0%, SFGR 23.3%, and TGR 0.6%. On univariate analysis, seropositivity for each pathogen was significantly associated with the following risk factors: B. anthracis with province of residence; Brucella spp. with sex, education level, and wealth; SFGR with age, education level, wealth, and province of residence; and TGR with province of residence. On multivariate analysis, seropositivity remained significantly associated with wealth and province for B. anthracis; with sex and age for Brucella spp; and with sex, education level, and province of residence for SFGR whereas TGR had no significance. High IgG seropositivity to these zoonotic pathogens (especially, B. anthracis and SFGR) suggests substantial exposure. These pathogens should be considered in the differential diagnosis of febrile illness in Kenya.
Highlights
Bacterial zoonotic pathogens are enzootic and endemic in many regions of the world, resulting in high morbidity and mortality, economic burden, and burden on the health-care system.[1,2,3] In sub-Saharan Africa (SSA), bacterial zoonotic diseases are often undiagnosed because of limited diagnostic capacities and nonspecific clinical presentations, low index of clinical suspicion, leading to inappropriate treatment, which often results in poor prognosis.[4,5] Nonspecific clinical symptoms for bacterial zoonotic pathogens include fever, joint pains, and headache.[4]
We evaluated serologic evidence of exposure to Bacillus anthracis, Brucella spp., spotted fever group rickettsioses (SFGR), and typhus group rickettsioses (TGR) from samples of persons aged 15–64 years collected during a nationwide human immunodeficiency virus (HIV) serosurvey conducted in 2007 in Kenya
Samples with adequate volume were randomly selected using STATA v12.1 (College Station, TX). This was done based on proportional sampling across the eight provinces of Kenya to test for evidence of previous exposure to bacterial zoonotic pathogens including B. anthracis, Brucella spp., SFGR, and TGR
Summary
Bacterial zoonotic pathogens are enzootic and endemic in many regions of the world, resulting in high morbidity and mortality, economic burden, and burden on the health-care system.[1,2,3] In sub-Saharan Africa (SSA), bacterial zoonotic diseases are often undiagnosed because of limited diagnostic capacities and nonspecific clinical presentations, low index of clinical suspicion, leading to inappropriate treatment (especially in malaria-endemic areas), which often results in poor prognosis.[4,5] Nonspecific clinical symptoms for bacterial zoonotic pathogens include fever, joint pains, and headache.[4] Other factors that contribute to the risk of bacterial zoonotic diseases in SSA include human and livestock or wildlife interactions such as eating undercooked meat and drinking unpasteurized milk from infected animals and arthropod contact. Brucellosis has previously been reported as commonly occurring in pastoralist communities in SSA,[8] whereas undiagnosed rickettsial infections are prevalent in northeastern and western Kenya.[2,9] Rodents and domestic animals live in close proximity to humans in many SSA countries and may harbor several tick and flea species that are potential vectors of rickettsial pathogens.[2,9] Typically, IgG antibodies for different pathogens persist over a long period, but durability for this persistence is
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