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. 2024 Sep;14(3):1305-1318.
doi: 10.1007/s44197-024-00288-4. Epub 2024 Sep 4.

Epidemiology of Q Fever in Southeast Europe for a 20-Year Period (2002-2021)

Tatjana Pustahija  1   2 , Snežana Medić  3   4 , Vladimir Vuković  3   4 , Zagorka Lozanov-Crvenković  5 , Aleksandra Patić  4   6 , Mirjana Štrbac  4 , Verica Jovanović  7 , Dragana Dimitrijević  7 , Milunka Milinković  7 , Mirjana Lana Kosanović  8 , Helena C Maltezou  9 , Kassiani Mellou  10 , Sanjin Musa  11   12 , Marijan Bakić  13 , Sanja Medenica  13 , Nikolina Sokolovska  14 , Nina Vukmir Rodić  15   16 , Milica Devrnja  4 , Mioljub Ristić #  3   4 , Vladimir Petrović #  3   4
Affiliations

Epidemiology of Q Fever in Southeast Europe for a 20-Year Period (2002-2021)

Tatjana Pustahija et al. J Epidemiol Glob Health. 2024 Sep.

Abstract

This study aimed to assess epidemiological trends of Q fever in six countries of Southeast Europe by analysing surveillance data for 2002-2021 period. In this descriptive analysis, we collected and analysed data on confirmed human Q fever cases, obtained from the national Public Health Institutes of Bosnia and Herzegovina, Croatia, Greece, Montenegro, North Macedonia and Serbia. Overall, 2714 Q fever cases were registered during the 20-year period. The crude average annual notification rate was 0.82 (± 2.06) (95% CI: 0.47-1.16) per 100,000 inhabitants, ranged from 0.06 (± 0.04) (95% CI: 0.04-0.08) /100,000 in Greece to 2.78 (± 4.80) (95% CI: 0.53-5.02) /100,000 in the Republic of Srpska (entity of Bosnia and Herzegovina). Significant declining trends of Q fever age standardized rates were registered in Croatia, the Federation of Bosnia and Herzegovina, North Macedonia and Serbia, with an average annual change of -30.15%; -17.13%; -28.33% and - 24.77%, respectively. An unequal spatial distribution was observed. The highest average age-specific notification rate was reported in the 20-59 age group (0.84 (± 0.40) (95% CI: 0.65-1.02) /100,000). Most cases (53.69%) were reported during the spring. Q fever remains a significant public health threat in this part of Europe. The findings of this study revealed the endemic maintenance of this disease in the including countries, with large regional and subnational disparities in notification rates. A downward trend was found in Q fever notification rates across the study countries with the average notification rate higher than in the EU/EEA, during the same period.

Keywords: Coxiella burnetii; Epidemiology; Q fever; Southeast Europe; Surveillance.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(a) The crude average annual notification rate of Q fever by SEE countries and B&H entities, 2002–2021. (b) Average age standardized notification rate of Q fever of SEE countries including B&H entities, 2002–2021
Fig. 2
Fig. 2
Distribution of Q fever cases by the administrative area in four SEE coutries (B&H, Croatia, Montenegro, Serbia), 2002–2021
Fig. 3
Fig. 3
Joinpoint regression analysis plot of Q fever ASR trends for five SEE countries (Croatia, the Federation of B&H, Montenegro, North Macedonia and Serbia), 2002–2021
Fig. 4
Fig. 4
Joinpoint regression analysis plot of Q fever ASR trends for SEE countries, 2002–2021
See this image and copyright information in PMC

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