Marami Dadi, Mihret Adane, Assefa Nega, Abdissa Alemseged, Osman Mahlet, Gemechu Gizachew, Witherbee Jacob S, Mulu Adargachew, Tschopp Rea
College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
PLoS Negl Trop Dis. 2025 Aug 13;19(8):e0013375. doi: 10.1371/journal.pntd.0013375. eCollection 2025 Aug.
Rift Valley fever (RVF) virus and Coxiella burnetii infections are significant public health concerns in East Africa, causing recurring outbreaks. However, the prevalence of these pathogens among febrile patients in Ethiopia remains unknown. This study aimed to determine the prevalence and associated factors of these infections among febrile patients.
A multisite cross-sectional study was conducted among 415 randomly selected adult febrile patients from health facilities in Shinile and Dire Dawa, Ethiopia, between March 01, 2023, and February 28, 2024. Serum samples were tested for the presence of antibodies against RVF virus and C. burnetii infections using various Enzyme Linked Immunosorbent Assays. Polymerase Chain Reaction (PCR) was used to detect RVF virus RNA and C. burnetii DNA in blood samples. A multivariable logistic regression model was used to identify predictive factors. A p value <0.05 was considered statistically significant.
Of the 402 serum samples analyzed, 21 (5.2%) tested positive for immunoglobulin G (IgG) antibodies against RVF virus, and 86 (21.4%) tested positive for C. burnetii Phase I and Phase II antibodies. No RVF virus IgM was detected. Among the C. burnetii antibodies positive sera, 6 (7.0%) were positive for Phase II IgG antibodies. No blood samples tested positive for RVF virus RNA or C. burnetii DNA. Febrile patients aged ≥35 years had significantly higher odds of RVF virus exposure (AOR: 3.1, 95% CI: 1.3-7.8). Females (AOR: 1.7, 95% CI: 1.1-2.9), rural residents (AOR: 2.4, 95% CI: 1.3-4.5), and febrile patients who disposed of dead animals (AOR: 2.6, 95% CI: 1.2-5.6) exhibited significantly higher odds of C. burnetii infection.
This study reveals significant but underrecognized exposure to RVF virus (5.2%) and C. burnetii (21.4%) infections among febrile patients. Risk factors for RVF included older age, whereas C. burnetii infection was associated with females, rural residents, and exposure to dead animals. Health authorities are advised to consider these infections in the differential diagnosis of fever, implement active surveillance, and target public health interventions.
裂谷热（RVF）病毒和贝氏柯克斯体感染是东非重大的公共卫生问题，会引发反复的疫情爆发。然而，这些病原体在埃塞俄比亚发热患者中的流行情况仍不清楚。本研究旨在确定这些感染在发热患者中的流行率及相关因素。
2023年3月1日至2024年2月28日期间，在埃塞俄比亚希尼勒和德雷达瓦的医疗机构中，对415名随机选取的成年发热患者进行了多地点横断面研究。使用各种酶联免疫吸附测定法检测血清样本中抗RVF病毒和贝氏柯克斯体感染的抗体。采用聚合酶链反应（PCR）检测血液样本中的RVF病毒RNA和贝氏柯克斯体DNA。使用多变量逻辑回归模型确定预测因素。p值<0.05被认为具有统计学意义。
在分析的402份血清样本中，21份（5.2%）抗RVF病毒免疫球蛋白G（IgG）抗体检测呈阳性，86份（21.4%）贝氏柯克斯体I期和II期抗体检测呈阳性。未检测到RVF病毒IgM。在贝氏柯克斯体抗体阳性血清中，6份（7.0%）II期IgG抗体呈阳性。没有血液样本检测出RVF病毒RNA或贝氏柯克斯体DNA呈阳性。年龄≥35岁的发热患者感染RVF病毒的几率显著更高（调整后比值比：3.1，95%置信区间：1.3 - 7.8）。女性（调整后比值比：1.7，95%置信区间：1.1 - 2.9）、农村居民（调整后比值比：2.4，95%置信区间：1.3 - 4.5）以及处理过死动物的发热患者（调整后比值比：2.6，95%置信区间：1.2 - 5.6）感染贝氏柯克斯体的几率显著更高。
本研究揭示了发热患者中存在显著但未得到充分认识的RVF病毒（5.2%）和贝氏柯克斯体（21.4%）感染情况。RVF的危险因素包括年龄较大，而贝氏柯克斯体感染与女性、农村居民以及接触死动物有关。建议卫生当局在发热的鉴别诊断中考虑这些感染，实施主动监测，并针对性地开展公共卫生干预措施。
