Çıtıl Rıza, Eğri Mücahit, Önder Yalçın, Duygu Fazilet, Bulut Yunus Emre, Yaşayancan Özkan, Yıldız Çeltek Nagehan, Şahin Şafak
Tokat Gaziosmanpaşa University, Faculty of Medicine, Department of Public Health, Tokat, Turkey.
Goethe University Frankfurt, Department of Internal Medicine, Infectious Diseases, Frankfurt, Germany.
J Trop Med. 2021 May 17;2021:9945089. doi: 10.1155/2021/9945089. eCollection 2021.
Turkey is one of the countries that has the most cases of CCHF in recent years among the endemic countries. The disease also poses an important health threat with high mortality rate. The aim of the study was to determine the seroprevalence and risk factors of CCHF in adults aged ≥20 years in Tokat in the endemic region, Turkey.
In this population-based cross-sectional study, a total of 85 Family Medicine Units (FMUs), from over 170 in Tokat, were randomly selected using 50% sampling. The sample size was determined among the subjects aged ≥20 who registered with the FMUs, due to gender, age group, and the urban/rural population size of Tokat using the stratified cluster sampling method. Subjects were invited to the FMUs. A questionnaire was performed face to face. The blood samples were taken, and anti-CCHFV IgG antibodies were measured with ELISA method.
1272 (54.9%) out of 2319 participants were female, and the mean age was 47.3 ± 15.3. Anti-CCHFV IgG seropositivity was 5.6% ( = 130). Seropositivity rates in terms of adjusted odds ratios (AOR) were higher 2.53 times (95% CI: 1.57-4.08; =0.001) in males; 4.05 (95% CI: 2.14-7.65; < 0.001) in age group ≥65; 0.33 (95% CI: 0.14-0.76; < 0.001) in graduates of high school and above; 0.71 (95%CI: 0.33-1.52; < 0.001) in ones with good income; 1.84 (95%CI: 1.18-2.86; < 0.001) in farmers; 1.64 (95% CI: 1.04-2.27; < 0.001) in people dealing with animal husbandry; and 1.02 (95% CI: 1.03-2.29; < 0.001) in those with history of tick contact.
CCHF seroprevalence is still a common public health problem in Tokat, Turkey. Male gender, advanced age group, low-educated, low-income, farmers, animal husbandry, and history of tick contact were found to be risk factors for CCHF. The importance of this kind of community-based studies to identify the seroprevalence in regional and national level increases even more.
土耳其是近年来地方性流行国家中克里米亚-刚果出血热（CCHF）病例数最多的国家之一。该疾病还因高死亡率对健康构成重大威胁。本研究的目的是确定土耳其地方性流行地区托卡特≥20岁成年人中CCHF的血清阳性率及危险因素。
在这项基于人群的横断面研究中，从托卡特170多个家庭医学单位（FMU）中随机抽取50%，共85个。采用分层整群抽样方法，根据性别、年龄组以及托卡特的城乡人口规模，在向FMU登记的≥20岁受试者中确定样本量。受试者被邀请到FMU。进行面对面问卷调查。采集血样，采用酶联免疫吸附测定（ELISA）法检测抗CCHFV IgG抗体。
2319名参与者中，1272名（54.9%）为女性，平均年龄为47.3±15.3岁。抗CCHFV IgG血清阳性率为5.6%（n = 130）。调整优势比（AOR）方面的血清阳性率在男性中高2.53倍（95%置信区间：1.57 - 4.08；P = 0.001）；≥65岁年龄组中为4.05（95%置信区间：2.14 - 7.65；P < 0.001）；高中及以上学历者中为0.33（95%置信区间：0.14 - 0.76；P < 0.001）；收入良好者中为0.71（95%置信区间：0.33 - 1.52；P < 0.001）；农民中为1.84（95%置信区间：1.18 - 2.86；P < 0.001）；从事畜牧业者中为1.64（95%置信区间：1.04 - 2.27；P < 0.001）；有蜱虫接触史者中为1.02（95%置信区间：1.03 - 2.29；P < 0.001）。
在土耳其托卡特，CCHF血清阳性率仍是一个常见的公共卫生问题。男性、高龄组、低学历、低收入、农民、畜牧业以及蜱虫接触史被发现是CCHF的危险因素。这类基于社区的研究对于确定地区和国家层面的血清阳性率的重要性进一步增加。
