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Endemicity of Coxiella burnetii infection among people and their livestock in pastoral communities in northern Kenya

Muema, Josphat; Nyamai, Mutono; Wheelhouse, Nick; Njuguna, Joseph; Jost, Christine; Oyugi, Julius; Bukania, Zipporah; Oboge, Harriet; Ogoti, Brian; Makori, Anita; Fernandez, Maria del Pilar; Omulo, Sylvia; Thumbi, S.M.


Josphat Muema

Mutono Nyamai

Joseph Njuguna

Christine Jost

Julius Oyugi

Zipporah Bukania

Harriet Oboge

Brian Ogoti

Anita Makori

Maria del Pilar Fernandez

Sylvia Omulo

S.M. Thumbi


Coxiella burnetti can be transmitted to humans primarily through inhaling contaminated droplets released from infected animals or consumption of contaminated dairy products. Despite its zoonotic nature and the close association pastoralist communities have with their livestock, studies reporting simultaneous assessment of C. burnetti exposure and risk-factors among people and their livestock are scarce.
This study therefore estimated the seroprevalence of Q-fever and associated risk factors of exposure in people and their livestock.
Materials and methods
We conducted a cross-sectional study in pastoralist communities in Marsabit County in northern Kenya. A total of 1,074 women and 225 children were enrolled and provided blood samples for Q-fever testing. Additionally, 1,876 goats, 322 sheep and 189 camels from the same households were sampled. A structured questionnaire was administered to collect individual- and household/herd-level data. Indirect IgG ELISA kits were used to test the samples.
Household-level seropositivity was 13.2% [95% CI: 11.2–15.3]; differences in seropositivity levels among women and children were statistically insignificant (p = 0.8531). Lactating women had higher odds of exposure, odds ratio (OR) = 2.4 [1.3–5.3], while the odds of exposure among children increased with age OR = 1.1 [1.0–1.1]. Herd-level seroprevalence was 83.7% [81.7–85.6]. Seropositivity among goats was 74.7% [72.7–76.7], while that among sheep and camels was 56.8% [51.2–62.3] and 38.6% [31.6–45.9], respectively. Goats and sheep had a higher risk of exposure OR = 5.4 [3.7–7.3] and 2.6 [1.8–3.4], respectively relative to camels. There was no statistically significant association between Q-fever seropositivity and nutrition status in women, p = 0.900 and children, p = 1.000. We found no significant association between exposure in people and their livestock at household level (p = 0.724) despite high animal exposure levels, suggesting that Q-fever exposure in humans may be occurring at a scale larger than households.
The one health approach used in this study revealed that Q-fever is endemic in this setting. Longitudinal studies of Q-fever burden and risk factors simultaneously assessed in human and animal populations as well as the socioeconomic impacts of the disease and further explore the role of environmental factors in Q-fever epidemiology are required. Such evidence may form the basis for designing Q-fever prevention and control strategies.

Journal Article Type Article
Acceptance Date Oct 13, 2022
Online Publication Date Oct 21, 2022
Publication Date 2022-10
Deposit Date Oct 24, 2022
Publicly Available Date Oct 24, 2022
Journal Heliyon
Print ISSN 2405-8440
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 8
Issue 10
Article Number e11133
Keywords Endemicity, Coxiella burnetii, Q-fever, People, Livestock, Pastoral, Kenya
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