Infectious and Rare Diseases

Biography

Biography: Rasoolgul Samar

Abstract

Q-fever (QF) is an endemic zoonotic disease in Afghanistan. In order to better understand risk factors for exposure and the clinical pattern of the disease, a case-control study was conducted in Helmand province.

In 2014, 100 patients presenting with fever of unknown origin (FUO) to a comprehensive health center were identified and enrolled in the study. A standardized questionnaire about exposure to potential Q-fever risk factors was administered to each patient and paired blood specimens (14 days apart) were collected to determine if the patient had been exposed to Coxiella burnetii, the causative agent for Q-fever.

Q-fever exposure status could be determined in 84 of the 100 patients. Of these, 47.6% were positive (cases) and 52.4% were negative (controls). Among the cases, 27.5% were categorised as acutely affected while 72.5%were categorised as chronically affected. There were no detectable differences in the pattern or duration of fever between the acutely and chronically affected patients.

Amongst the 19 risk factor variables that were examined, only gender was significantly associated with QF seropositivity. Females were approximately four times more likely to be a case than  males. In contrast to previously reported risk factors for QF in Afghanistan and other parts of the world, neither routine exposure to livestock nor the presence of rodents in a person’s living compound appeared to be associated with QF seropositivity.

The likelihood of exposure to QF amongst FUO patients was high in this study. In the absence of a national control program for the disease, people in Afghanistan remain at high risk for exposure and further research should be conducted to determine if unique risk factors are present in Helmand that were not identified in this study or if FUO patients are atypical with regard to their exposure to risk factors found to be important in other studies.