Abstract

Crimean–Congo hemorrhagic fever (CCHF) remains a major tick-borne zoonotic infection and a persistent public health challenge in Central Asia. Kazakhstan is among the endemic countries, where natural foci of CCHF are concentrated predominantly in the southern regions. This study evaluated the long-term epidemiological trends, regional distribution, seasonality, and risk factors associated with CCHF in Kazakhstan. A retrospective analysis of national surveillance data from 1980 to 2023 was conducted, complemented by detailed epidemiological and entomological investigations in the Turkestan region and the city of Shymkent during 2011–2023. Laboratory-confirmed cases, tick bite-related healthcare visits, entomological surveillance data, demographic characteristics, and epidemiological risk factors were analyzed. The results demonstrated cyclic fluctuations in CCHF incidence, with epidemic peaks occurring every 4–6 years and pronounced spring–summer seasonality, with the highest incidence observed in June and July. Long-term average annual incidence in endemic southern regions exceeded the national average by 2.67-fold. A total of 50,671 tick bite-related healthcare visits were registered during 2011–2023, while their incidence declined over time. Analysis of 94 laboratory-confirmed cases identified adults aged 18–40 years as the most affected group. Tick bites and livestock-related activities were the principal risk factors. These findings support the strengthening of integrated surveillance, vector control, laboratory diagnostics, and One Health-based prevention strategies in endemic regions.

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