{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:11:55Z","timestamp":1782213115779,"version":"3.54.5"},"reference-count":0,"publisher":"World Health Organization Regional Office for the Eastern Mediterranean (WHO\/EMRO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["East Mediterr Health J."],"published-print":{"date-parts":[[2024,1,21]]},"abstract":"<jats:p>Background: Some review papers and meta-analyses have investigated seroprevalence and fatality trends of the CrimeanCongo hemorrhagic fever (CCHF), but it is not clear if its seroprevalence is increasing. Aim: To investigate the trend in the seroprevalence of CCHF. Methods: We conducted a secondary analysis of the results of a meta-analysis of the seroprevalence of CCHF published in 2019. We used a multilevel mixed effects Poisson regression to find the predictors of seropositivity. To explain the magnitude effect, we reported an incidence rate ratio (IRR) with a 95% confidence interval (CI). We conducted multilevel modeling using Stata 14 for data analysis. Results: In the fixed effects model, time was significantly associated with increased seropositivity (IRR = 1.025, 95% CI = 1.021\u20131.030), and no significant association was found for local sampling (IRR = 1.026, 95% CI = 0.988\u20131.065). In the mixed effects model, random intercepts of the country and parallel of latitude were applied as 3 levels of the model (prevalence rate of each study, nested within countries and latitude parallel). Accordingly, time was significantly associated with a reduction of seropositivity (IRR = 0.899, 95% CI = 0.891\u20130.907), and local sampling was significantly associated with increased seropositivity (IRR = 2.477, 95% CI = 2.316\u20132.649). Conclusion: Despite reporting increasing trends for seroprevalence of CCHF in previous reviews and the fixed effects model of the present study, the secondary mixed effects modeling showed a decreasing trend. The multilevel generalized model is recommended for such temporal and spatial designs in the future.<\/jats:p>","DOI":"10.26719\/emhj.24.006","type":"journal-article","created":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T10:11:42Z","timestamp":1705831902000},"page":"68-76","source":"Crossref","is-referenced-by-count":4,"title":["Secondary multilevel mixed-effects modelling of seroprevalence trends of Crimean\u2013Congo haemorrhagic fever"],"prefix":"10.26719","volume":"30","author":[{"given":"Seyyed AY","family":"Ahmadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad S","family":"Baghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razieh","family":"Shirzadegan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Nasirian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11263","published-online":{"date-parts":[[2024,1,21]]},"container-title":["Eastern Mediterranean Health Journal"],"original-title":[],"link":[{"URL":"https:\/\/applications.emro.who.int\/EMHJ\/V30\/01\/1020-3397-2024-3001-68-76-eng.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T10:11:44Z","timestamp":1705831904000},"score":1,"resource":{"primary":{"URL":"https:\/\/applications.emro.who.int\/EMHJ\/V30\/01\/1020-3397-2024-3001-68-76-eng.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,21]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1,21]]},"published-print":{"date-parts":[[2024,1,21]]}},"URL":"https:\/\/doi.org\/10.26719\/emhj.24.006","relation":{},"ISSN":["1020-3397","1687-1634"],"issn-type":[{"value":"1020-3397","type":"print"},{"value":"1687-1634","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,21]]}}}