title: Crimean-Congo Hemorrhagic Fever Knowledge, Attitudes, Practices, Risk Factors, and Seroprevalence in Rural Georgian Villages with Known Transmission in 2014.
abstract: In 2014 the highest annual case count of Crimean-Congo hemorrhagic fever (CCHF) was detected in Georgia since surveillance began in 2009. CCHF is a high-fatality hemorrhagic syndrome transmitted by infected ticks and animal blood. In response to this immediate public health threat, we assessed CCHF risk factors, seroprevalence, and CCHF-related knowledge, attitudes, and practices in the 12 rural villages reporting a 2014 CCHF case, to inform CCHF prevention and control measures. Households were randomly selected for interviewing and serum sample collection. Data were weighted by non-response and gender; percentages reflect weighting. Among 618 respondents, median age was 54.8 years (IQR: 26.5, range: 18.6-101.4); 215 (48.8%) were male. Most (91.5%) participants reported ≥1 CCHF high-risk activity. Of 389 participants with tick exposure, 286 (46.7%) participants handled ticks bare-handed; 65/216 (29.7%) knew the risk. Of 605 respondents, 355 (57.9%) reported animal blood exposure; 32/281 (12.7%) knew the risk. Of 612 responding, 184 (28.8%) knew protective measures against CCHF and tick exposures, but only 54.3% employed the measures. Of 435 serum samples collected, 12 were anti-CCHF IgG positive, indicating a weighted 3.0% seroprevalence. Most (66.7%) seropositive subjects reported tick exposure. In these villages, CCHF risk factors are prevalent, while CCHF-related knowledge and preventive practices are limited; these findings are critical to informing public health interventions to effectively control and prevent ongoing CCHF transmission. Additionally, CCHF seroprevalence is higher than previously detected (0.03%), highlighting the importance of this disease in the South Caucuses and in supporting ongoing regional investigations.
authors.affiliation: Epidemic Intelligence Service, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.|Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Greiner
authors.affiliation: National Center for Disease Control and Public Health, Tbilisi, Georgia.
authors.forename: Nana
authors.initials: N
authors.lastname: Mamuchishvili
authors.affiliation: National Center for Disease Control and Public Health, Tbilisi, Georgia.
authors.forename: Natia
authors.initials: N
authors.lastname: Kakutia
authors.affiliation: South Caucasus Country Office, Center for Global Health, United States Centers for Disease Control and Prevention, Tbilisi, Georgia.
authors.forename: Kendra
authors.initials: K
authors.lastname: Stauffer
authors.affiliation: South Caucasus Country Office, Center for Global Health, United States Centers for Disease Control and Prevention, Tbilisi, Georgia.
authors.forename: Marika
authors.initials: M
authors.lastname: Geleishvili
authors.affiliation: National Center for Disease Control and Public Health, Tbilisi, Georgia.|R. G. Lugar Center for Public Health Research, Tbilisi, Georgia.
authors.forename: Nazibrola
authors.initials: N
authors.lastname: Chitadze
authors.affiliation: National Center for Disease Control and Public Health, Tbilisi, Georgia.|R. G. Lugar Center for Public Health Research, Tbilisi, Georgia.
authors.forename: Tamar
authors.initials: T
authors.lastname: Chikviladze
authors.affiliation: National Center for Disease Control and Public Health, Tbilisi, Georgia.
authors.forename: Khatuna
authors.initials: K
authors.lastname: Zakhashvili
authors.affiliation: South Caucasus Country Office, Center for Global Health, United States Centers for Disease Control and Prevention, Tbilisi, Georgia.
authors.forename: Juliette
authors.initials: J
authors.lastname: Morgan
authors.affiliation: Division of Global Health Protection, Center for Global Health, United States Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Salyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005843:Geography; D005846:Georgia (Republic) / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012424:Rural Population; D016036:Seroepidemiologic Studies; D012959:Socioeconomic Factors; D055815:Young Adult