A statistical approach to understand Crimean-Congo hemorrhagic fever prevalence in Pakistan

Abstract: Geographically, Pakistan is in the western part of south Asia at about 24-37 °N latitudes and62-75 °E longitudes. Livestock and agriculture are two major sectors in Pakistan and play animportant role in the country economy.The tick infestation in livestock is not only devastating for animals and their products but alsobecome the cause of transmission of pathogens into humans. Crimean Congo fever (CCHF) isa viral tick-borne fatal disease. The dissemination of ticks and amplification of Crimean Congofever (CCHF) pathogen throughout the tick-animals-tick cycle, increases risk of transmissionto humans many times. In Pakistan, cases are reported in all areas, particularly those areaswhich lie on the border to CCHF endemic countries. There is a high prevalence of CCHF inboth Baluchistan and Khyber Pakhtunkhwa regions. Baluchistan is bordering with Afghanistanand Iran and Khyber Pakhtunkhwa with Afghanistan. Linear regression analysis revealed apositive significant association of high level of CCHF cases in livestock, with camels, goatsand sheep. The literacy rate is negatively significantly corelated with the numbers of cases.Statistical analysis of border effect revealed a high positive significant correlation of CCHFprevalence in areas near to borders. Both Baluchistan and Khyber Pakhtunkhwa (KPK) haslow literacy rate than other regions of Pakistan. Islamabad (capital city) has a higher literacyrate than all other regions but there is still a high CCHF prevalence. This is not only becauseof high population density but people from other regions, particularly from Baluchistan andKPK come here for animals selling or to seeking medical facilities in the large city hospitals.The study gives a proof that illiteracy and borders are the major respondent factors in theCCHF incidences and prevalence in an area. There is a need to raise awareness about ticksand tick-borne disease in the public and establishment of monitoring system across the bordersto prevent the spread of CCHF virus.