Cross-Sectional Study of Brucellosis, Q Fever and CCHF Prevalence, Afghanistan

Brucellosis, Q fever and CCHF are endemic in ruminants in Afghanistan and are the main zoonoses effecting the human population of Afghanistan. Except for some records of outbreaks, the country lacks data on these diseases. This study aimed to provide information on the prevalence and concurrent status of brucellosis, Q fever and CCHF in humans and livestock in 11 randomly selected villages in Herat Province.  The principal epidemiologic unit of interest were households containing both animals and humans. A total of 204 households were surveyed in 11 villages, six of which were nomadic Kuchi and five were sedentary.  In each household whole blood samples were collected from up to 5 human subjects from age 8-60, up to 10 randomly selected female sheep and goats and up to 5 female cattle of breeding age.  Blood samples were collected from 1,017 humans, 2,032 small ruminants (877 goats and 1,155 sheep) and 350 cattle.  An AHVLA Scientific cELISA was conducted on all samples that were RBT-positive and the tests were interpreted in series.  All human and animal sera were then tested for Q fever with a commercial iELISAs; LSI™ LSIVET for animal and an IBL international two phase ELISA for human sera.  Due to budget limitations, sera have been frozen at CVDRL and CPHL for CCHF testing at a future date. Approximately one in six households (15.69%) had at least one Brucella seropositive person. About one in seven households (13.24%) had at least one Brucella seropositive animal.  97.6% of households had at least one Q fever seropositive person and 98.52% of households had one or more Q fever seropositive animals.  47 people had serological evidence of exposure to both Q fever and Brucella antibodies and 20 animals tested positive for both diseases.   This project not only revealed the presence of Q fever and Brucella in households in Herat province, but also provided a framework of a collaborative methodology with which animal and human health professionals from government (central and provincial), NGOs and donor-funded projects in Afghanistan can work together.  The information collected will act as a baseline for planning future interventions and monitoring changes in the prevalence over time.  It can also be used by individuals and organizations to provide evidence to policy makers for the need to create or modify policies or advocate for interventions. Acronyms: AHVLA (UK)-Animal Health and Veterinary Laboratories Agency (United Kingdom); CCHF-Crimean Congo Haemorrhagic Fever; cELISA-Competition ELISA; CPHL-Central Public Health Laboratory; CVDRL-Central Veterinary Diagnostic and Research Laboratory; ELISA-Enzyme Linked Immuno Sorbent Assay; iELISA-Indirect ELISA; RBT-Rose Bengal Test.