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Assessing the Prevalence & Clinical Features of Crimean-Congo Hemorrhagic Fever in Herat Regional Hospital, Afghanistan in 2024
<p><strong>Background:</strong> Crimean-Congo Hemorrhagic Fever (CCHF) is a severe viral infection caused by the Crimean-Congo Hemorrhagic Fever Virus (CCHFV). We aimed to assess the prevalence of CCHFV among individuals with clinical symptoms indicative of CCHF at the Herat regional hospital, Afghanistan in 2024, which provides diagnostic and treatment services to suspected CCHF patients in western Afghanistan.</p>
<p><strong>Methods: </strong>We used secondary data collected by Surveillance Department of the Afghanistan Ministry of Public Health (MoPH). Samples were collected from the provinces of Herat, Farah, Badghis, and Ghor. A retrospective cross-sectional design was employed. Participants were categorized into two groups (29 and 115 cases in each group) based on their CCHFV test results. Data included demographic information, clinical symptoms, and exposure history related to tick bites and contact with infected individuals. Statistical analysis was performed using IBM SPSS Statistics Version 25, employing Chi-square tests for categorical variables and <em>t</em>-tests for continuous variables.</p>
<p><strong>Results: </strong>Among the 144 participants, 29 (19.7%) tested positive for CCHFV, with the highest incidence occurring in July. The demographic profile indicated that 65.5% of positive cases were male, with a mean age of 33.2 years. Notably, 24.1% of the positive cohort reported tick bites, indicating a possible association between tick exposure and infection rates. All participants reported headaches and fever. Statistically significant differences (<em>P</em>-value < 0.05) were observed in three symptoms among positive group: epistaxis (55.2% ), conjunctival hemorrhage (3.4%), and vaginal bleeding (13.8%). Additionally, 93.1% of the positive group and 96.5% of the negative group received antiviral therapy.</p>
<p><strong>Conclusion: </strong>The findings underscore the need for targeted public health interventions, including enhanced surveillance and community education on tick prevention.</p>
<p> </p>
https://creativecommons.org/licenses/by/4.0
Nahid Ghazizada, Dr Nargis Neyazi, Dr Elham Tokhi, Ahmad Amin Ghazizada, Dr Nesar Neyazi, Dr Nadia Neyazi
2026
Crimean-Congo Hemorrhagic Fever (CCHF)
Tick-borne Disease
Prevalence
Afghanistan
Nahid
Ghazizada
Regional Reference Laboratory, Herat Regional Hospital, Herat-Afghanistan
AF
ghazizadanahid@gmail.com
Dr Nargis
Neyazi
Independent Researcher, California, USA
US
neyazinarges@gmail.com
Elham
Tokhi
Regional Reference Laboratory, Herat Regional Hospital, Herat-Afghanistan.
AF
tokhi2022@gmail.com
Ahmad Amin
Ghazizada
Department of Medical Technology, Varastegan Institute of Medical Sciences, Mashhad, Iran
AF
amin.ghazizadah@gmail.com
Nesar Zia
Neyazi
Khatam Al-Nabieen University, Kabul, Afghanistan
AF
nesarneyazi@yahoo.com
Nadia
Neyazi
Department of Human Genetics, Amsterdam University Medical Center, Amsterdam, Netherland
NL
nadianeyazi@yahoo.com
201
PDF
0
Hawman DW, Feldmann H. Crimean-Congo haemorrhagic fever virus. Nat Rev Microbiol. 2023; 21(7):463–77.
Bente DA, Forrester NL, Watts DM, McAuley AJ, Whitehouse CA, Bray M. Crimean-Congo hemor-rhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res. 2013; 100(1):159–89.
Fillâtre P, Revest M, Tattevin P. Crimean-Congo hemorrhagic fever: An update. Med Mal Infect. 2019; 49(8):574–85.
Kilinc C, Gückan R, Capraz M, Varol K, Zengin E, Mengeloglu Z, et al. Examination of the specific clinical symptoms and laboratory findings of Cri-mean-Congo hemorrhagic fever. J Vector Borne Dis. 2016; 53(2):162.
Norman FF, Arce OA, Díaz-Menéndez M, Belhas-sen-García M, González-Sanz M. Changes in the epidemiology of Crimean-Congo hemorrhagic fe-ver: Impact of travel and a One Health approach in the European region. Travel Med Infect Dis. 2025; 64:102806.
Sathyvathy G. Crimean-Congo Hemorrhagic Fever (CCHF). V Pub Int J Nurs Med Res. 2023 30; 2(2):52–5.
Frank MG, Weaver G, Raabe V. Crimean-Congo Hemorrhagic Fever Virus for Clinicians: Diagnosis, Clinical Management, and Therapeutics. Emerg In-fect Dis. 2024; 30(5); Available from: https://wwwnc.cdc.gov/eid/article/30/5/23-1648_article
European Center for Disease Prevention and Con-trol. Factsheet for health professionals about Crime-an-Congo hemorrhagic fever [Internet]. 2017 [cited 2026 Jan 17]. Available from: https://www.ecdc.europa.eu/en/crimean-congo-haemorrhagic-fever/facts/factsheet
Hamdard E, Zahir A, Mujadidi N, Himmat N. The silent threat of Crimean-Congo hemorrhagic fever: an epidemiologic analysis from five key high-risk regions of Afghanistan (2018–2024). IJID One Health. 2025; 1;7:100067.
Karakecili F, Cikman A, Aydin M, Binay UD, Kesik OA, Ozcicek F. Evaluation of epidemiologi-cal, clinical, and laboratory characteristics and mor-tality rate of patients with Crimean-Congo hemor-rhagic fever in the northeast region of Turkey. J Vector Borne Dis. 2018;55(3):215–21.
Qaderi S, Mardani M, Shah A, Shah J, Bazgir N, Sayad J, et al. Crimean-Congo Hemorrhagic Fever (CCHF) in Afghanistan: A retrospective single cen-ter study. Int J Infect Dis. 2021; 103:323–8.
Niazi A ur R, Jawad MJ, Amirnajad A, Durr PA, Williams DT. Crimean-Congo Hemorrhagic Fever, Herat Province, Afghanistan, 2017. Emerg Infect Dis. 2019; 25(8):1596–8.
The World Health Organization. Afghanistanout-break situation report, week 40-2024[Internet]. [cit-ed 2026 Jan 17]. Available from: https://www.emro.who.int/images/stories/afghanistan/Outbreak-Situation-Report-Week-40-2024.pdf
Gürbüz E, Ekici A, Ünlü AH, Yılmaz H. Evalua-tion of seroprevalence and clinical and laboratory findings of patients admitted to health institutions in Gümüşhane with suspicion of Crimean-Congo hemorrhagic fever. Turk J Med Sci. 2021; 51(4):1825–32.
Choubdar N, Oshaghi MA, Rafinejad J, Pourmand MR, Maleki-Ravasan N, Salehi-Vaziri M, et al. Ef-fect of Meteorological Factors on Hyalomma Spe-cies Composition and Their Host Preference, Sea-sonal Prevalence and Infection Status to Crimean-Congo Haemorrhagic Fever in Iran. J Arthropod-Borne Dis. 2019;13(3):268–83.
Sambado S, et al. Climate‐associated variation in the within‐season dynamics of juvenile ticks in Cal-ifornia.– Ecosphere. 2024;15(12):e70064 Available from: https://esajournals.onlinelibrary.wiley.com/doi/10.1002/ecs2.70064
Sharifi-Mood B, Metanat M, Alavi-Naini R. Preva-lence of Crimean-Congo Hemorrhagic Fever Among High Risk Human Groups. Int J High Risk Behav Addict. 2014;3(1):e11520.
A Comparison of Clinical and Laboratory Features of Crimean-Congo Hemorrhagic Fever in Children and Adults: A Retrospective Single-Center Cohort Study and Literature Review. Vector-Borne and Zoonotic Dis. 2024;24(6). Available from: https://www.liebertpub.com/doi/full/10.1089/vbz.2024.0066
Kaya A, Engin A, Güven AS, İçağasıoğlu FD, Cevit Ö, Elaldı N, et al. Crimean-Congo hemor-rhagic fever disease due to tick bite with very long incubation periods. Int J Infect Dis. 2011;15(7):e449–52.
de la Fuente J, Ghosh S, Lempereur L, Garrison A, Sprong H, Lopez-Camacho C, et al. Interventions for the control of Crimean-Congo hemorrhagic fe-ver and tick vectors. NPJ Vaccines. 2024; 9:181.
Tahir I, Motwani J, Moiz MA, Kumar V, Shah HH, Hussain MS, et al. Crimean-Congo hemor-rhagic fever outbreak affecting healthcare workers in Pakistan: an urgent rising concern. Ann Med Surg (Lond). 2024; 86(6):3201–3.
Srivastava S, Kumar S, Sharma PK, Rustagi S, Mohanty A, Donovan S, et al. Control strategies for emerging infectious diseases: Crimean-Congo hemorrhagic fever management. Health Sci Rep. 2024; 7(9):e70053.
Ahmed A, Saqlain M, Tanveer M, Tahir AH, Ud-Din F, Shinwari MI, et al. Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan. BMC Infect Dis. 2021;21(1):35.
Salimi M, Aghaei Afshar A, Limoee M, Babakhani S, Chatrabgoun O, Hanafi-Bojd AA, et al. Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran. Asian Pac J Trop Biomed. 2016; 6(6):546–50.
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Fourth Volume, second issue, July 2026
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