{"doi":"10.4269/ajtmh.20-1036","title":"Incidence Estimates of Acute Q Fever and Spotted Fever Group Rickettsioses, Kilimanjaro, Tanzania, from 2007 to 2008 and from 2012 to 2014","abstract":"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-coupling case-finding at two referral hospitals and healthcare utilization data-we 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 Coxiella burnetii phase II antigen for acute Q fever and Rickettsia conorii (2007-2008) or Rickettsia africae (2012-2014) 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, 20-454) and 147 (uncertainty range, 52-645) 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, 24-163) and 75 (uncertainty range, 34-176) 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.","journal":"American Journal of Tropical Medicine and Hygiene","year":2021,"id":161240,"datarank":0.8493441531104904,"base_score":3.367295829986474,"endowment":3.367295829986474,"self_citation_contribution":0.5050943744979712,"citation_network_contribution":0.3442497786125192,"self_endowment_contribution":0.5050943744979712,"citer_contribution":0.3442497786125192,"corpus_percentile":76.30540728707356,"corpus_rank":3064,"citation_count":28,"citer_count":15,"citers_with_citation_signal":9,"citers_with_endowment":9,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5302,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":345416,"name":"Matthew P. Rubach","orcid":"0000-0001-5262-1421","position":1,"is_corresponding":false},{"id":520529,"name":"Manuela Carugati","orcid":"0000-0002-3187-5905","position":2,"is_corresponding":false},{"id":675627,"name":"William L. Nicholson","orcid":"0000-0002-2215-6837","position":3,"is_corresponding":false},{"id":675628,"name":"Jamie L. Perniciaro","orcid":"0000-0002-7613-8984","position":4,"is_corresponding":false},{"id":24130,"name":"Holly M. Biggs","orcid":"0000-0002-4949-2232","position":5,"is_corresponding":false},{"id":372158,"name":"Michael J. Maze","orcid":"0000-0001-8909-1508","position":6,"is_corresponding":false},{"id":468962,"name":"Julian T. Hertz","orcid":"0000-0002-7396-4789","position":7,"is_corresponding":false},{"id":345422,"name":"Jo E. B. Halliday","orcid":"0000-0002-1329-9035","position":8,"is_corresponding":false},{"id":495855,"name":"Kathryn J. Allan","orcid":"0000-0001-6612-889X","position":9,"is_corresponding":false},{"id":341832,"name":"Blandina T. Mmbaga","orcid":"0000-0002-5550-1916","position":10,"is_corresponding":false},{"id":496728,"name":"Wilbrod Saganda","orcid":null,"position":11,"is_corresponding":false},{"id":495858,"name":"Bingileki F. Lwezaula","orcid":"0000-0003-2909-9705","position":12,"is_corresponding":false},{"id":345413,"name":"Rudovick Kazwala","orcid":"0000-0003-3918-1323","position":13,"is_corresponding":false},{"id":495857,"name":"Sarah Cleaveland","orcid":"0000-0002-0456-0959","position":14,"is_corresponding":false},{"id":345414,"name":"Venance P. Maro","orcid":"0000-0003-3838-0312","position":15,"is_corresponding":false},{"id":22443,"name":"John A. Crump","orcid":"0000-0002-4529-102X","position":16,"is_corresponding":false},{"id":676251,"name":"Sruti Pisharody","orcid":null,"position":0,"is_corresponding":true}],"reference_count":74,"raw_metadata":null,"created_at":"2026-07-18T23:44:52.299342Z","pmid":"34929672","pmcid":"PMC8832940","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}