Seroprevalence of Q fever among humans and animals in East Africa: a systematic review and meta-analysis

Q fever is a neglected zoonotic disease caused by Coxiella burnetii with a global distribution. It has a significant public health implication in resource-limited settings. Therefore, this systematic review and meta-analysis were designed to comprehensively analyze the seroprevalence of Q fever in humans and animals in East Africa. Following the PRISMA guidelines and a registered protocol on PROSPERO (CRD420251149865), online searches were conducted in Pubmed, ScienceDirect, Scopus, Web of Science, Google Scholar, and AJOL from October 1–5, 2025, to retrieve articles from the East African countries published within the time frame of January 1, 2000 and September 30, 2025. This systematic review and meta-analysis identified 47 articles reporting Q fever seroprevalence across multiple animal species and human, yielding 94 species-specific datasets for pooled analysis. After heterogeneity assessment, random effects model was used to estimate the pooled Q fever seroprevalence. The estimated pooled seroprevalence was 21.32% (95% CI: [14.58; 28.06]) among humans and 27.55% (95% CI: [22.34; 32.77]) in animals. Trim-and-fill analysis revealed substantial publication bias, reducing pooled seroprevalence from 27.55% to 8.46% in animals and from 21.35% to 6.98% in humans. The seroprevalence in humans was higher in Kenya (26.0%) and Ethiopia (24.7%) than in Sudan (18.0%), Tanzania (14.9%), and Uganda (7.6%). The multivariable meta-regression revealed a significant increasing trend in human Q fever seroprevalence over time, despite marginal non-significance in univariable analysis. Among animals, the seroprevalence was higher in camels (38.9%) and lower in cattle (14.6%), with observed statistically significant difference. This meta-analysis result showed that the seroprevalence of Q fever is high in humans and animals, but it is still neglected in many countries in the East Africa, posing significant impact to human and animal health. Planned preventive measures and control efforts are necessary.