Animal and Human Health Program, International Livestock Research Institute, Nairobi, 00100, Kenya.
Department of Veterinary Medicine, Freie Universität Berlin, 14163, Berlin, Germany.
Sci Rep. 2024 May 28;14(1):12263. doi: 10.1038/s41598-024-62714-8.
Bacterial zoonoses are diseases caused by bacterial pathogens that can be naturally transmitted between humans and vertebrate animals. They are important causes of non-malarial fevers in Kenya, yet their epidemiology remains unclear. We investigated brucellosis, Q-fever and leptospirosis in the venous blood of 216 malaria-negative febrile patients recruited in two health centres (98 from Ijara and 118 from Sangailu health centres) in Garissa County in north-eastern Kenya. We determined exposure to the three zoonoses using serological (Rose Bengal test for Brucella spp., ELISA for C. burnetti and microscopic agglutination test for Leptospira spp.) and real-time PCR testing and identified risk factors for exposure. We also used non-targeted metagenomic sequencing on nine selected patients to assess the presence of other possible bacterial causes of non-malarial fevers. Considerable PCR positivity was found for Brucella (19.4%, 95% confidence intervals [CI] 14.2-25.5) and Leptospira spp. (1.7%, 95% CI 0.4-4.9), and high endpoint titres were observed against leptospiral serovar Grippotyphosa from the serological testing. Patients aged 5-17 years old had 4.02 (95% CI 1.18-13.70, p-value = 0.03) and 2.42 (95% CI 1.09-5.34, p-value = 0.03) times higher odds of infection with Brucella spp. and Coxiella burnetii than those of ages 35-80. Additionally, patients who sourced water from dams/springs, and other sources (protected wells, boreholes, bottled water, and water pans) had 2.39 (95% CI 1.22-4.68, p-value = 0.01) and 2.24 (1.15-4.35, p-value = 0.02) times higher odds of exposure to C. burnetii than those who used unprotected wells. Streptococcus and Moraxella spp. were determined using metagenomic sequencing. Brucellosis, leptospirosis, Streptococcus and Moraxella infections are potentially important causes of non-malarial fevers in Garissa. This knowledge can guide routine diagnosis, thus helping lower the disease burden and ensure better health outcomes, especially in younger populations.
细菌性人畜共患病是由细菌病原体引起的疾病,这些病原体可以在人类和脊椎动物之间自然传播。它们是非疟疾发热在肯尼亚的重要病因,但它们的流行病学仍不清楚。我们调查了 216 例在肯尼亚东北部加里萨县两个卫生中心(伊加拉 98 例,桑盖卢 118 例)招募的疟疾阴性发热患者的静脉血中的布鲁氏菌病、Q 热和钩端螺旋体病。我们使用血清学(玫瑰红试验检测布鲁氏菌属,酶联免疫吸附试验检测 C. burnetti 和显微镜凝集试验检测钩端螺旋体属)和实时 PCR 检测来确定三种人畜共患病的暴露情况,并确定了暴露的危险因素。我们还对 9 名选定的患者进行了非靶向宏基因组测序,以评估其他可能导致非疟疾发热的细菌病因。布鲁氏菌属(19.4%,95%置信区间[CI] 14.2-25.5)和钩端螺旋体属的 PCR 阳性率相当高(1.7%,95%CI 0.4-4.9),并且从血清学检测中观察到针对血清型 Grippotyphosa 的高终点效价。年龄在 5-17 岁的患者感染布鲁氏菌属和寇热螺旋体的几率是 35-80 岁患者的 4.02(95%CI 1.18-13.70,p 值=0.03)和 2.42(95%CI 1.09-5.34,p 值=0.03)倍。此外,从水坝/泉水以及其他水源(受保护水井、钻孔、瓶装水和水盘)获取水源的患者感染寇热螺旋体的几率是从未受保护水井获取水源的患者的 2.39(95%CI 1.22-4.68,p 值=0.01)和 2.24(1.15-4.35,p 值=0.02)倍。使用宏基因组测序确定了链球菌属和莫拉菌属。布鲁氏菌病、钩端螺旋体病、链球菌属和莫拉菌属感染可能是加里萨县非疟疾发热的重要病因。这一知识可以指导常规诊断,从而降低疾病负担,确保更好的健康结果,尤其是在年轻人群中。