{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:03:56Z","timestamp":1787241836202,"version":"build-2736575974"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance\u2014coupling case-finding at two referral hospitals and healthcare utilization data\u2014we estimated the incidences of acute Q fever and SFGR in Moshi, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014. Cases were defined as fever and a four-fold or greater increase in antibody titers of acute and convalescent paired sera according to the indirect immunofluorescence assay of\n                    <jats:italic>Coxiella burnetii<\/jats:italic>\n                    phase II antigen for acute Q fever and\n                    <jats:italic>Rickettsia conorii<\/jats:italic>\n                    (2007\u20132008) or\n                    <jats:italic>Rickettsia africae<\/jats:italic>\n                    (2012\u20132014) antigens for SFGR. Healthcare utilization data were used to adjust for underascertainment of cases by sentinel surveillance. For 2007 to 2008, among 589 febrile participants, 16 (4.7%) of 344 and 27 (8.8%) of 307 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 80 (uncertainty range, 20\u2013454) and 147 (uncertainty range, 52\u2013645) per 100,000 persons, respectively. For 2012 to 2014, among 1,114 febrile participants, 52 (8.1%) and 57 (8.9%) of 641 participants with paired serology had Q fever and SFGR, respectively. Adjusted annual incidence estimates of Q fever and SFGR were 56 (uncertainty range, 24\u2013163) and 75 (uncertainty range, 34\u2013176) per 100,000 persons, respectively. We found substantial incidences of acute Q fever and SFGR in northern Tanzania during both study periods. To our knowledge, these are the first incidence estimates of either disease in sub-Saharan Africa. Our findings suggest that control measures for these infections warrant consideration.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.20-1036","type":"journal-article","created":{"date-parts":[[2021,12,20]],"date-time":"2021-12-20T07:54:00Z","timestamp":1639986840000},"page":"494-503","source":"Crossref","is-referenced-by-count":25,"title":["Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014"],"prefix":"10.4269","volume":"106","author":[{"given":"Sruti","family":"Pisharody","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew P.","family":"Rubach","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina;"},{"name":"2Duke Global Health Institute, Duke University, Durham, North Carolina;"},{"name":"3Programme in Emerging Infectious Diseases, Duke-National University of Singapore, Singapore;"},{"name":"4Kilimanjaro Christian Medical Centre, Moshi, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Carugati","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"5Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie L.","family":"Perniciaro","sequence":"additional","affiliation":[{"name":"5Centers for Disease Control and Prevention, Rickettsial Zoonoses Branch, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly M.","family":"Biggs","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Maze","sequence":"additional","affiliation":[{"name":"4Kilimanjaro Christian Medical Centre, Moshi, Tanzania;"},{"name":"6Centre for International Health, University of Otago, Dunedin, New Zealand;"},{"name":"7Department of Medicine, University of Otago, Christchurch, New Zealand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian T.","family":"Hertz","sequence":"additional","affiliation":[{"name":"2Duke Global Health Institute, Duke University, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo E. B.","family":"Halliday","sequence":"additional","affiliation":[{"name":"8Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom;"},{"name":"9Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn J.","family":"Allan","sequence":"additional","affiliation":[{"name":"8Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom;"},{"name":"9Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blandina T.","family":"Mmbaga","sequence":"additional","affiliation":[{"name":"4Kilimanjaro Christian Medical Centre, Moshi, Tanzania;"},{"name":"10Kilimanjaro Christian Medical University College, Moshi, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilbrod","family":"Saganda","sequence":"additional","affiliation":[{"name":"11Mawenzi Regional Referral Hospital, Moshi, Tanzania;"},{"name":"12Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingileki F.","family":"Lwezaula","sequence":"additional","affiliation":[{"name":"11Mawenzi Regional Referral Hospital, Moshi, Tanzania;"},{"name":"12Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudovick R.","family":"Kazwala","sequence":"additional","affiliation":[{"name":"13Sokoine University of Agriculture, Morogoro, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Cleaveland","sequence":"additional","affiliation":[{"name":"8Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom;"},{"name":"9Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venance P.","family":"Maro","sequence":"additional","affiliation":[{"name":"4Kilimanjaro Christian Medical Centre, Moshi, Tanzania;"},{"name":"10Kilimanjaro Christian Medical University College, Moshi, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Crump","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases and International Health, Department of Medicine, Duke University, Durham, North Carolina;"},{"name":"2Duke Global Health Institute, Duke University, Durham, North Carolina;"},{"name":"4Kilimanjaro Christian Medical Centre, Moshi, Tanzania;"},{"name":"6Centre for International Health, University of Otago, Dunedin, New Zealand;"},{"name":"10Kilimanjaro Christian Medical University College, Moshi, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p494.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/2\/article-p494.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T09:58:44Z","timestamp":1643795924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/2\/article-p494.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,2]]},"references-count":0,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1036","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,2]]}}}