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Q Fever in Africa and Asia a systematic literature review and mapping of disease ILR I INTERNATIONAL LIVESTOCK RESEARCH INSTITUTE Funding for this research was provided by the Department for International Development, UK Delia Grace 1 , Pamela Ochungo 1 and Eline Boelee 2 1- International Livestock Research Institute, Nairobi, Kenya 2 – Water Health, Hollandsche Rading, the Netherlands Introduction: Q-fever • Emerging disease caused by the bacterium Coxiella burnetii • Widespread in cattle, sheep and goats, companion animals and wildlife • Causes abortion in sheep and goats resulting in economic losses • Highly contagious to people: o Affects ~ 3.5 million people each year o Kills ~ 3,000 people annually Materials and methods • Systematic review • Search of PubMed, CABDIRECT, AJOL and Google • Screening abstracts: last 10 years, Africa or Asia, geographical datal, information on sampling • Prevalence based on serology • Distinguish between ‘community surveys’ of general population and surveys of high risk populations • Map using ArcGIS v10 against base map of farming systems Results - Regional prevalence • 83 surveys covering 27,470 animals and 11,311 people • Prevalence in community studies: North Africa 20% of people and animals West Africa 29% East Africa 12% South Africa 18% South Asia 20% South East Asia 1% Results - Associations • High correlation between prevalence in livestock and people in the same country: 0.8 • Negative correlation between poultry/per person and prevalence: – 0.46 • Moderate positive correlation between cattle/per person (0.14) and small ruminant per person (0.20) and prevalence. • No association with religion/culture: 18% prevalence in Muslim countries and 17% for non-Muslim Conclusions • Q fever has been linked before with drier regions, small ruminant keeping systems and Muslim countries: our review suggested Q fever was more widely distributed • Q fever is common in people and animals in poor countries • Little is known about the distribution, risk factors or impacts • Research needs include: Results - Prevalence in livestock and people • Prevalence in community studies: bovines 26% cats and dogs 13% sheep 16% goats 12% other animals (camels, donkeys, pigs and poultry) 29% people in these communities 18% • Febrile patients in hospitals: 8% (range 0-40%) had evidence of current infection AGRICULTURE FOR NUTRITION AND HEALTH New research program of the Consultative Group on International Agricultural Research (CGIAR), led by the International Food Policy Research Institute (IFPRI), aims at improving nutrition and health of poor people, especially women and young children. It will do this by exploiting and enhancing the synergies between agriculture, nutrition and health, through four research components: • Improving nutrition along value chains • Improving availability, access and intake of bio-fortified staple foods • Addressing food safety issues along value chains and managing agriculture associated diseases • Integrating agriculture, nutrition and health sectors o Prevalence studies in more countries o Assess economic impacts of Q fever in livestock o Investigate possible under-diagnosis of Q fever o Better understanding of risk factors and drivers o Identify factors leading to outbreaks in human populations
