{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:05:35Z","timestamp":1793329535224,"version":"4.5.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,2]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>Crimean-Congo hemorrhagic fever (CCHF) is endemic in Africa, but the epidemiology remains to be defined. Using a broad database search, we reviewed the literature to better define CCHF evidence in Africa. We used a One Health approach to define the impact of CCHF by reviewing case reports, human and animal serology, and records of CCHF virus (CCHFV) isolations (1956\u2013mid-2020). In addition, published and unpublished collection data were used to estimate the geographic distribution of <jats:italic>Hyalomma<\/jats:italic> ticks and infection vectors. We implemented a previously proposed classification scheme for organizing countries into five categories by the level of evidence. From January 1, 1956 to July 25, 2020, 494 CCHF cases (115 lethal) were reported in Africa. Since 2000, nine countries (Kenya, Mali, Mozambique, Nigeria, Senegal, Sierra Leone, South Sudan, Sudan, and Tunisia) have reported their first CCHF cases. Nineteen countries reported CCHF cases and were assigned level 1 or level 2 based on maturity of their surveillance system. Thirty countries with evidence of CCHFV circulation in the absence of CCHF cases were assigned level 3 or level 4. Twelve countries for which no data were available were assigned level 5. The goal of this review is to inform international organizations, local governments, and healthcare professionals about shortcomings in CCHF surveillance in Africa to assist in a movement toward strengthening policy to improve CCHF surveillance.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1413","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T13:29:16Z","timestamp":1619443756000},"page":"1978-1990","source":"Crossref","is-referenced-by-count":105,"title":["Epidemiology of Crimean-Congo Hemorrhagic Fever (CCHF) in Africa\u2014Underestimated for Decades"],"prefix":"10.4269","volume":"104","author":[{"given":"Ahmet Irfan","family":"Temur","sequence":"first","affiliation":[{"name":"1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland;"},{"name":"2Bezmialem Vakif University, Istanbul, Turkey;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens H.","family":"Kuhn","sequence":"additional","affiliation":[{"name":"3Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Pecor","sequence":"additional","affiliation":[{"name":"4Department of Entomology, Walter Reed Biosystematics Unit, Smithsonian Institution, Suitland, Maryland;"},{"name":"5Department of Entomology, Walter Reed Army Institute of Research, Silver Spring, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry A.","family":"Apanaskevich","sequence":"additional","affiliation":[{"name":"6US National Tick Collection, The James H. Oliver Jr. Institute for Coastal Plain Science, Georgia Southern University, Statesboro, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Keshtkar-Jahromi","sequence":"additional","affiliation":[{"name":"1Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland;"}],"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\/104\/6\/article-p1978.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/6\/article-p1978.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T16:39:40Z","timestamp":1622651980000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/6\/article-p1978.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,2]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1413","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,2]]}}}