A One Health systematic review and meta-analysis of Coxiella burnetii prevalence in humans, animals, and vectors in Algeria
Clinical Snapshot
PICO Framework
| P — Population | Humans, domestic animals (cattle, small ruminants, camels), and arthropod vectors (ticks) in Algeria |
| I — Intervention | Not applicable (observational study) |
| C — Comparator | Prevalence comparison across different host species, regions, and diagnostic methods |
| O — Outcomes | Prevalence of Coxiella burnetii infection detected by serological or molecular methods |
Bottom Line
This systematic review provides the first comprehensive quantitative assessment of Coxiella burnetii prevalence across humans, animals, and vectors in Algeria using a One Health approach. The study demonstrates widespread circulation with camels serving as the primary reservoir (73.7% prevalence), followed by small ruminants (15.8%) and cattle (11.8%). Human infection prevalence was relatively low (3.7%) but represents significant public health risk given close livestock contact in rural communities. The high heterogeneity between studies (I² > 75%) limits confidence in pooled estimates and suggests substantial variation in study methods, populations, and regional factors. The absence of quality assessment details further constrains interpretation. Despite these limitations, the findings support urgent implementation of integrated One Health surveillance systems and targeted control strategies, particularly in southeastern Algeria where prevalence was highest. Healthcare providers should maintain high clinical suspicion for Q fever in patients with livestock exposure, especially those handling camels or small ruminants.
Key Findings
P Value: Not reported in abstract
Effect Size: Camels: 73.7%, Small ruminants: 15.8%, Cattle: 11.8%, Ticks: 10.0%, Humans: 3.7%
Primary Outcome: Pooled prevalence of Coxiella burnetii across different host species in Algeria
Nnt Or Sensitivity: High prevalence in camels (73.7%) indicates major reservoir species for zoonotic transmission risk
Confidence Interval: Camels: 66.5-79.8%, Small ruminants: 10.6-22.9%, Cattle: 7.2-18.8%, Ticks: 3.2-27.1%, Humans: 0.9-13.9%
Clinical Application
Results support targeted surveillance in high-risk populations and animals, particularly camel handlers and those in southeastern regions Limited direct applicability to Australia due to different livestock systems and C. burnetii epidemiology, though One Health surveillance principles remain relevant for Australian Q fever control programs Healthcare workers, veterinarians, livestock handlers, and public health officials in Algeria and similar North African settings
Abstract
Coxiella burnetii, the causative agent of Q fever, is a globally distributed zoonotic pathogen affecting humans, domestic animals, and arthropod vectors. In Algeria, fragmented data suggest widespread circulation, yet no comprehensive quantitative assessment exists. This study aimed to systematically review and meta-analyse the prevalence of C. burnetii in humans, animals, and vectors in Algeria, using a One Health perspective. A systematic search of PubMed, Scopus, Web of Science, and Google Scholar was conducted up to January 2026. Studies reporting serological or molecular detection of C. burnetii in Algeria were included. Random-effects meta-analysis was performed to estimate pooled prevalence, with subgroup analyses by host species, region, and diagnostic method. A total of 35 studies were included, encompassing 8,372 samples and 80 prevalence observations. Pooled prevalence was highest in camels (73.7%; 95% CI: 66.5-79.8%), followed by small ruminants (15.8%; 95% CI: 10.6-22.9%) and cattle (11.8%; 95% CI: 7.2-18.8%). Ticks showed a pooled prevalence of 10.0% (95% CI: 3.2-27.1%), while human infection had a pooled prevalence of 3.7% (95% CI: 0.9-13.9%). The south-eastern region exhibited the highest prevalence, and serological methods generally reported higher rates than molecular methods. High heterogeneity (I² > 75%) was observed across studies. Coxiella burnetii is widely circulating among humans, domestic animals, camels, and ticks in Algeria, with notable variation between hosts and regions. Camels and small ruminants act as major reservoirs, while humans remain at risk, particularly those in close contact with livestock. Integrated One Health surveillance and targeted control strategies are urgently needed to reduce the burden of Q fever.
References
- 1.Yousfi, S., Fares, R., Khelifi Touhami, N. A., Salhi, O., & Ouchene, N. (2026). A One Health systematic review and meta-analysis of Coxiella burnetii prevalence in humans, animals, and vectors in Algeria. Veterinaria italiana. https://doi.org/10.12834/VetIt.3935.40059.3
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