Occurrence of Anti-Rickettsia spp. Antibodies in Hospitalized Patients with Undifferentiated Febrile Illness in the Southern Region of Kazakhstan

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  • 1 Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan;
  • 2 Department of Infectious and Tropical Diseases, Kazakh National Medical University, Almaty, Kazakhstan;
  • 3 National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan;
  • 4 Department of Children’s Infectious Diseases, Kazakh National Medical University, Almaty, Kazakhstan;
  • 5 Scientific Practical Center of Sanitary Epidemiological Expertise and Monitoring, Almaty, Kazakhstan;
  • 6 Scientific Clinical Diagnostic Laboratory, Kazakh National Medical University, Almaty, Kazakhstan;
  • 7 Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany;
  • 8 Al-Farabi Kazakh National University, Almaty, Kazakhstan;
  • 9 Institute of General Genetics and Cytology, Almaty, Kazakhstan;
  • 10 Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany;
  • 11 Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, German Center for Infection Research, Munich Partner site, Munich, Germany;
  • 12 Bundeswehr Research Institute for Protective Technologies and CBRN Protection, Munster, Germany

Undifferentiated febrile illness still represents a demanding medical problem all over the world, but primarily in low- and middle-income countries. Scientific and clinical investigations related to undifferentiated febrile illness and rickettsial diseases in Kazakhstan are lacking. This study reflects the investigation of antibodies against spotted fever group (SFG) and typhus group (TG) rickettsiae in patients with undifferentiated febrile illness in the southern region of Kazakhstan (Almaty and Kyzylorda oblasts). Paired serum samples were gathered from 13 hospitals in these two oblasts and explored for the presence of IgM and IgG antibodies against typhus group and IgG antibodies against spotted fever group rickettsiae using ELISA. Patient’s questionnaires were statistically analyzed. In total, 802 inpatients from Almaty (N = 9) and Kyzylorda (N = 4) hospitals were included in this research. Based on ELISA results, 250 patients out of 802 (31.2%) from both oblasts had IgG antibodies against SFG rickettsiae. Results from 11 (1.4%) patients indicated acute infection with tick-borne rickettsiosis. Regarding TG rickettsiae (R. typhi), a past infection was detected in 248 (30.9%) febrile patients and acute infection in 22 (2.7%) patients in the two selected oblasts. The data indicated that SFG and TG rickettsioses are present in Kazakhstan. Kazakh physicians should be aware of these emerging diseases in both investigated oblasts because the occurrence of these diseases is not suspected during day-to-day clinical practice. The identification of rickettsial pathogens and implementation of modern laboratory methods for the diagnostics of rickettsioses are in need throughout Kazakhstan.

Author Notes

Financial support: This research was funded by the German Federal Foreign Office within the framework of the global partnership German Biosecurity Program. This study was conducted with collaboration between Bundeswehr Institute of Microbiology, Kazakh National Medical University and Scientific Practical Center of Sanitary Epidemiological Expertise and Monitoring.

Disclaimer: All ethical issues were reviewed and approved by the national Kazakh Ethical Committee from Kazakh National Medical University and by the ethical committee from the Ludwig-Maximilians-Universität in Germany. The authors declare that they have no competing interests. The opinions expressed by the authors contributing to this study do not necessarily reflect the opinions of the involved institutes.

Authors’ addresses: Nurkeldi Turebekov and Karlygash Abdiyeva, Central Reference Laboratory, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan, E-mails: nurkeldi.turebekov@lrz.uni-muenchen.de and karlygash.abdiyeva@lrz.uni-muenchen.de. Ravilya Yegemberdiyeva, Department of Infectious and Tropical Diseases, Kazakh National Medical University, Almaty, Kazakhstan, E-mail: regemberdieva@rambler.ru. Andrey Kuznetsov and Andrey Dmitrovskiy, National Scientific Center for Especially Dangerous Infections, Almaty, Kazakhstan, E-mails: dr.a.n.kuznetsov@gmail.com and am_dmitr@mail.ru. Lyazzat Yeraliyeva, Department of Children’s Infectious Diseases, Kazakh National Medical University, Almaty, Kazakhstan, E-mail: l.eralieva@mail.ru. Zhanna Shapiyeva, Scientific Practical Center of Sanitary Epidemiological Expertise and Monitoring, Almaty, Kazakhstan, E-mail: z.shapiyeva@gmail.com. Dinara Batyrbayeva, Scientific Clinical Diagnostic Laboratory, Kazakh National Medical University, Almaty, Kazakhstan, E-mail: dinarabat@mail.ru. Nur Tukhanova and Anna Shin, Center for International Health, Ludwig-Maximilians-Universität, Munich, Germany, E-mails: tukhanovanur@gmail.com and annashin86@gmail.com. Lyazzat Musralina, Institute of General Genetics and Cytology, Almaty, Kazakhstan, E-mail: musralinal@gmail.com. Michael Hoelscher, Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, German Center for Infection Research, Munich Partner site, Munich, Germany, E-mail: hoelscher@lrz.uni-muenchen.de. Guenter Froeschl, Division of Infectious Diseases and Tropical Medicine, University Hospital, Ludwig-Maximilians-Universität, and German Center for Infection Research, Munich Partner site, Munich, Germany, E-mail: froeschl@lrz.uni-muenchen.de. Gerhard Dobler, Klaus Freimueller, Edith Wagner, and Sandra Essbauer, Bundeswehr Institute of Microbiology, Department Virology & Rickettsiology, Munich, Germany, E-mails: gerharddobler@bundeswehr.org, klausfreimueller@bundeswehr.org, edithwagner@bundeswehr.org, and sandraessbauer@bundeswehr.org. Stefan Frey, Bundeswehr Research Institute for Protective Technologies, and CBRN Protection, Munster, Germany, E-mail: stefan1frey@bundeswehr.org.

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