National serosurvey and risk mapping reveal widespread distribution of Coxiella burnetii in Kenya.

Coxiella burnetii, the causative agent of Q fever, is an emerging pathogen that has the potential to cause severe chronic infections in animals and humans worldwide. The detrimental impact on public health is projected to be higher in the low- and middle-income countries given their lower capacity to sustain effective surveillance and response measures. We implemented a national serosurvey of cattle in Kenya to map the spatial distribution of the pathogen. The study used serum samples that were collected from randomly selected cattle in different ago-ecological zones across the country. These samples were screened for the pathogen using PrioCHECK Ruminant Q Fever AB Plate ELISA kit. The laboratory findings were analyzed using INLA package to identify risk factors for C. burnetii exposure from herd- and animal-level factors, area, and bioclimatic datasets accessed from online databases. A total of 6,593 cattle were recruited for the study; of these, 7.9% (95% CI; 7.2-8.5) were seropositive. Outputs from the multivariable analysis revealed that the animal age and some of the geographical variables including wind speed, area under shrubs and "petric calcisols" type of soil were significantly associated with C. burnetii seropositivity. Being a calf, weaner or subadult was associated with lower odds of exposure compared to being an adult by 0.24 (credibility interval: 2.5% and 97.5%), 0.41 (0.30-0.55) and 0.51 (0.38-0.69), respectively. In addition, a unit increase in the wind speed increased the odds of C. burnetii seropositivity by 1.27 (1.05-1.52) while an increase on the land area under shrubs was associated with lower odds of exposure (0.67 [0.47-0.69]). The effect of petric calcisols was non-linear; an increase of the land area with this soil type was associated with an exponential increase in C. burnetii seropositivity. This study provides new data on C. burnetii seroprevalence, information of its risk factors and a prevalence map that can be used for C. burnetii risk surveillance and control. The identification of environmental risk factors for C. burnetii exposure, and the increasing awareness of the zoonotic potential of the pathogen, calls for the need to enhance the existing collaborations for the surveillance and control of C. burnetii in line with the One Health framework. The evidence generated on the potential role of environmental factors can also be used to design nature-based interventions, such as replacement of vegetation in denuded areas, to reduce potential for the aerosolization of the pathogen. Livestock vaccination in the hotspots would also reduce animal infections and hence the contamination of the environment.