Department of Epidemiology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Public Health of Vojvodina, Novi Sad, Serbia.
J Epidemiol Glob Health. 2024 Sep;14(3):1305-1318. doi: 10.1007/s44197-024-00288-4. Epub 2024 Sep 4.
This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.
本研究旨在通过分析 2002-2021 年期间的监测数据，评估东南欧六个国家的 Q 热流行病学趋势。在这项描述性分析中，我们收集并分析了来自波斯尼亚和黑塞哥维那、克罗地亚、希腊、黑山、北马其顿和塞尔维亚国家公共卫生研究所的确诊人类 Q 热病例数据。在 20 年期间，共登记了 2714 例 Q 热病例。粗平均年通报率为 0.82（±2.06）（95%CI：0.47-1.16）/100,000 居民，范围为 0.06（±0.04）（95%CI：0.04-0.08）/100,000 在希腊到 2.78（±4.80）（95%CI：0.53-5.02）/100,000 在波斯尼亚和黑塞哥维那的斯普斯卡共和国（实体）。在克罗地亚、波斯尼亚和黑塞哥维那联邦、北马其顿和塞尔维亚，Q 热年龄标准化率呈显著下降趋势，年均变化分别为-30.15%；-17.13%；-28.33%和-24.77%。观察到空间分布不均。报告的最高平均年龄特异性通报率出现在 20-59 岁年龄组（0.84（±0.40）（95%CI：0.65-1.02）/100,000）。大多数病例（53.69%）发生在春季。Q 热仍然是欧洲这一地区的重大公共卫生威胁。本研究结果显示，包括国家在内的该疾病持续存在地方性流行，通报率在地区和次国家之间存在较大差异。在研究国家中，Q 热通报率呈下降趋势，同期平均通报率高于欧盟/欧洲经济区。
