Berrian, Amanda M.Martínez-Lopez, BeatrizQuan, VanessaConrad, Patricia A.Van Rooyen, JacquesSimpson, Gregory J.G.Frean, JohnWeyer, JacquelineRossouw, JenniferKnobel, Darryn LeslieBlumberg, Lucille Hellen2020-06-012019-08Berrian AM, Martínez‐López B, Quan V, et al. Risk factors for bacterial zoonotic pathogens in acutely febrile patients in Mpumalanga Province, South Africa. Zoonoses Public Health. 2019;66:458–469. https://doi.org/10.1111/zph.12577.1863-1959 (print)1863-2378 (online)10.1111/zph.12577http://hdl.handle.net/2263/74802Endemic zoonoses, such as Q fever and spotted fever group (SFG) rickettsiosis, are prevalent in South Africa, yet often undiagnosed. In this study, we reviewed the demographics and animal exposure history of patients presenting with acute febrile illness to community health clinics in Mpumalanga Province to identify trends and risk factors associated with exposure to Coxiella burnetii , the causative agent of Q fever, and infection by SFG Rickettsia spp. Clinical and serological data and questionnaires elucidating exposure to animals and their products were obtained from 141 acutely febrile patients between 2012 and 2016. Exposure or infection status to C. burnetii and SFG Rickettsia spp. was determined by presence of IgG or IgM antibodies. Logistic regression models were built for risk factor analysis. Clinical presentation of patients infected by SFG rickettsiosis was described. There were 37/139 (27%) patients with a positive C. burnetii serology, indicative of Q fever exposure. Patients who had reported attending cattle inspection facilities (“dip tanks”) were 9.39 times more likely to be exposed to Q fever (95% CI: 2.9–30.4). Exposure risk also increased with age (OR: 1.03, 95% CI: 1.002–1.06). Twenty‐one per cent of febrile patients (24/118) had evidence of acute infection by SFG Rickettsia spp. Similarly, attending cattle inspection facilities was the most significant risk factor (OR: 8.48, 95% CI: 1.58–45.60). Seropositivity of females showed a significant OR of 8.0 when compared to males (95% CI: 1.49–43.0), and consumption of livestock was associated with a decreased risk (OR: 0.02, 95% CI: 0.001–0.54). A trend between domestic cat contact and SFG rickettsiosis was also noted, albeit borderline non‐significant. In this endemic region of South Africa, an understanding of risk factors for zoonotic pathogens, including exposure to domestic animals, can help clinic staff with diagnosis and appropriate therapeutic management of acutely febrile patients as well as identify target areas for education and prevention strategies.en© 2019 Blackwell Verlag GmbH. This is the pre-peer reviewed version of the following article : Risk factors for bacterial zoonotic pathogens in acutely febrile patients in Mpumalanga Province, South Africa. Zoonoses Public Health. 2019;66:458–469. https://doi.org/10.1111/zph.12577. The definite version is available at : http://wileyonlinelibrary.com/journal/zph.One healthQ feverQuestionnaireSpotted fever group (SFG) rickettsiosisTick‐borneZoonosesSouth Africa (SA)Veterinary science articles SDG-03Veterinary science articles SDG-11SDG-03: Good health and well-beingSDG-11: Sustainable cities and communitiesPostprint Article