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Abstract：
BACKGROUND: Crimean Congo hemorrhagic fever (CCHF) is endemic in Southern Mauritania where recurrent outbreaks have been constantly observed since the 1980\'s. The present study is the first to assess CCHFV antibodies and RNA in humans.
METHODS: A retrospective study was conducted using 263 humans and 1380 domestic animals serum samples, and 282 tick specimens of Hyalomma genus collected from 54 settings in 12 provinces across Mauritania. Antibodies targeting CCHF viral nucleoprotein were detected in animal and human sera using double-antigen ELISA. CCHFV specific RNA was detected in human and animal sera as well as tick supernatants using a CCHFV real time RT-PCR kit. Individual characteristics of sampled hosts were collected at the same time and data were geo-referenced. Satellite data of several environmental and climatic factors, were downloaded from publicly available datasets, and combined with data on livestock mobility, animal and human density, road accessibility and individual characteristics to identify possible risk factors for CCHFV spatial distribution. To this end, multivariate logistic models were developed for each host category (human, small and large ruminants).
RESULTS: The overall CCHFV antibody prevalence was 11.8% [95% CI: 8.4-16.3] in humans (17.9% in 2020 and 5.4% in 2021; p = 0.0017) and 33.1% (95% CI: 30.1-36.3) in livestock. CCHFV-specific antibodies were detected in 91 (18.1%) out of 502 sheep, 43 (9.0%) out of 477 goats, 144 (90.5%) out of 161 dromedaries and 179 (74.6%) out of 240 cattle. CCHFV RNA was detected in only 2 (0.7%) sera out of 263 animals herders samples from Hodh El Gharbi province and in 32 (11.3%) out of 282 Hyalomma ticks. In humans as well as in animals, seropositivity was not associated with sex or age groups. The multivariate analysis determined the role of different environmental, climatic and anthropic factors in the spatial distribution of the disease with animal mobility and age being identified as risk factors.
CONCLUSIONS: Results of the present study demonstrate the potential risk of CCHF for human population in Mauritania primarily those living in rural areas in close vicinity with animals. Future studies should prioritize an integrative human and veterinary approach for better understanding and managing Crimean-Congo hemorrhagic fever.
METHODS: A retrospective study was conducted using 263 humans and 1380 domestic animals serum samples, and 282 tick specimens of Hyalomma genus collected from 54 settings in 12 provinces across Mauritania. Antibodies targeting CCHF viral nucleoprotein were detected in animal and human sera using double-antigen ELISA. CCHFV specific RNA was detected in human and animal sera as well as tick supernatants using a CCHFV real time RT-PCR kit. Individual characteristics of sampled hosts were collected at the same time and data were geo-referenced. Satellite data of several environmental and climatic factors, were downloaded from publicly available datasets, and combined with data on livestock mobility, animal and human density, road accessibility and individual characteristics to identify possible risk factors for CCHFV spatial distribution. To this end, multivariate logistic models were developed for each host category (human, small and large ruminants).
RESULTS: The overall CCHFV antibody prevalence was 11.8% [95% CI: 8.4-16.3] in humans (17.9% in 2020 and 5.4% in 2021; p = 0.0017) and 33.1% (95% CI: 30.1-36.3) in livestock. CCHFV-specific antibodies were detected in 91 (18.1%) out of 502 sheep, 43 (9.0%) out of 477 goats, 144 (90.5%) out of 161 dromedaries and 179 (74.6%) out of 240 cattle. CCHFV RNA was detected in only 2 (0.7%) sera out of 263 animals herders samples from Hodh El Gharbi province and in 32 (11.3%) out of 282 Hyalomma ticks. In humans as well as in animals, seropositivity was not associated with sex or age groups. The multivariate analysis determined the role of different environmental, climatic and anthropic factors in the spatial distribution of the disease with animal mobility and age being identified as risk factors.
CONCLUSIONS: Results of the present study demonstrate the potential risk of CCHF for human population in Mauritania primarily those living in rural areas in close vicinity with animals. Future studies should prioritize an integrative human and veterinary approach for better understanding and managing Crimean-Congo hemorrhagic fever.
摘要：
背景：克里米亚刚果出血热（CCHF）是毛里塔尼亚南部的地方病，自1980年代以来一直在反复爆发。本研究是第一个评估人类CCHFV抗体和RNA的研究。
方法：使用263人和1380只家畜血清样本进行了回顾性研究，从毛里塔尼亚12个省的54个环境中收集了282个Hyalomma属的tick虫标本。使用双抗原ELISA在动物和人血清中检测靶向CCHF病毒核蛋白的抗体。使用CCHFV实时RT-PCR试剂盒在人和动物血清以及蜱上清液中检测CCHFV特异性RNA。同时收集采样宿主的个体特征，并对数据进行地理参考。几个环境和气候因素的卫星数据，是从公开可用的数据集中下载的，结合牲畜流动性的数据，动物和人类的密度，道路可达性和个体特征，以识别CCHFV空间分布的可能风险因素。为此,为每个宿主类别开发了多变量逻辑模型(人类，小型和大型反刍动物)。
结果：人类的总体CCHFV抗体患病率为11.8％[95％CI：8.4-16.3]（2020年为17.9％，2021年为5.4％；p=0.0017）和33.1％（95％CI：30.1-36.3）。502只绵羊中有91只(18.1%)检测到CCHFV特异性抗体，477只山羊中有43只(9.0%)，161头牛中有144头（90.5%），240头牛中有179头（74.6%）。在来自HodhElGharbi省的263只动物牧民样品中，只有2只（0.7％）血清中检测到CCHFVRNA，在282个Hyalomma壁虱中检测到32只（11.3％）。在人类和动物中，血清阳性与性别或年龄组无关。多变量分析确定了不同环境的作用，该疾病的空间分布中的气候和人为因素，动物的流动性和年龄被确定为危险因素。
结论：本研究的结果表明，在毛里塔尼亚，主要是生活在农村地区与动物关系密切的人群中，CCHF的潜在风险。未来的研究应优先考虑人和兽医的综合方法，以更好地理解和管理克里米亚-刚果出血热。
方法：使用263人和1380只家畜血清样本进行了回顾性研究，从毛里塔尼亚12个省的54个环境中收集了282个Hyalomma属的tick虫标本。使用双抗原ELISA在动物和人血清中检测靶向CCHF病毒核蛋白的抗体。使用CCHFV实时RT-PCR试剂盒在人和动物血清以及蜱上清液中检测CCHFV特异性RNA。同时收集采样宿主的个体特征，并对数据进行地理参考。几个环境和气候因素的卫星数据，是从公开可用的数据集中下载的，结合牲畜流动性的数据，动物和人类的密度，道路可达性和个体特征，以识别CCHFV空间分布的可能风险因素。为此,为每个宿主类别开发了多变量逻辑模型(人类，小型和大型反刍动物)。
结果：人类的总体CCHFV抗体患病率为11.8％[95％CI：8.4-16.3]（2020年为17.9％，2021年为5.4％；p=0.0017）和33.1％（95％CI：30.1-36.3）。502只绵羊中有91只(18.1%)检测到CCHFV特异性抗体，477只山羊中有43只(9.0%)，161头牛中有144头（90.5%），240头牛中有179头（74.6%）。在来自HodhElGharbi省的263只动物牧民样品中，只有2只（0.7％）血清中检测到CCHFVRNA，在282个Hyalomma壁虱中检测到32只（11.3％）。在人类和动物中，血清阳性与性别或年龄组无关。多变量分析确定了不同环境的作用，该疾病的空间分布中的气候和人为因素，动物的流动性和年龄被确定为危险因素。
结论：本研究的结果表明，在毛里塔尼亚，主要是生活在农村地区与动物关系密切的人群中，CCHF的潜在风险。未来的研究应优先考虑人和兽医的综合方法，以更好地理解和管理克里米亚-刚果出血热。
