纳米比亚无偿献血者中伯氏考克斯氏体、斑点热群立克次体、斑疹伤寒群立克次体及汉赛巴尔通体的暴露情况和危险因素。
Exposure and risk factors to coxiella burnetii, spotted fever group and typhus group Rickettsiae, and Bartonella henselae among volunteer blood donors in Namibia.
作者信息
Noden Bruce H, Tshavuka Filippus I, van der Colf Berta E, Chipare Israel, Wilkinson Rob
机构信息
Department of Biomedical Science, Polytechnic of Namibia, Windhoek, Namibia.
Department of Microbiology, Namibia Institute of Pathology, Oshakati, Namibia.
出版信息
PLoS One. 2014 Sep 26;9(9):e108674. doi: 10.1371/journal.pone.0108674. eCollection 2014.
BACKGROUND
The 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 FINDINGS: The 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/SIGNIFICANCE: These 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.
背景
病原体介导的发热性疾病在撒哈拉以南非洲的作用正受到更多关注，尤其是在南部非洲，有四个国家（包括纳米比亚）正在积极努力消除疟疾。由于纳米比亚牲畜高度集中且伴侣动物拥有率高，人畜共患细菌性疾病作为发热性疾病病因的影响尚不清楚。
方法/主要发现：本研究的目的是使用间接免疫荧光法（IFA）和酶联免疫吸附测定（ELISA，检测IgG），对纳米比亚输血服务中心（NAMBTS）确定的319名志愿献血者的血清进行检测，以评估其是否接触过贝纳柯克斯体、斑点热群立克次体和斑疹伤寒群立克次体以及汉赛巴尔通体。血清样本与一份基本问卷相关联，以确定可能的风险因素。大多数参与者（64.8%）曾大量接触农村地区或农场。结果显示，贝纳柯克斯体的流行率为26.1%（筛查滴度1∶16），斑点热群立克次体和斑疹伤寒群立克次体的流行率分别为11.9%和14.9%（筛查滴度1∶100）。在纳米比亚南部，贝纳柯克斯体暴露与居住地点之间存在显著的空间关联（P<0.021）。从事与动物相关职业的献血者（P>0.012），尤其是与牛相关职业的献血者（P>0.006），也与贝纳柯克斯体暴露显著相关。男性接触斑点热群立克次体（P<0.013）和斑疹伤寒群立克次体（P<0.011）的可能性明显高于女性。三份（2.9%）样本汉赛巴尔通体呈阳性，这可能表明纳米比亚人对这种从未有过报告的病原体的接触水平较低。
结论/意义：这些结果表明，纳米比亚人接触致病性发热细菌，其中大多数以跳蚤或蜱作为传播媒介/宿主。纳米比亚发热性疾病的流行病学需要进一步评估，以便制定全面的当地诊断和治疗方案。
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