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Background Coxiella burnetti, the causal agent of Q-fever, contributes to aetiologies of fevers of unknown origin (FUO) in West Africa. We compared its seroprevalence between Dakar, the largest urban centre in Senegal, and Niakhar, a rural area, and investigated the association to contacts with livestock and dairy products consumption. Methods Large cross-sectional surveys; households randomly selected using a two-stage cluster sampling. Within households, 1-2 participants were randomly selected using a Kish grid. A small blood sample was collected to detect phase 1 and 2 Coxiella burnetti IgG using ELISA, and a questionnaire was administered. Random effect logistic regression models were used to measure the association with risk factors. Results Overall, 2102 participants recruited in Dakar and 1156 in Niakhar. The prevalence of C. burnetti was high in both settings, but higher in rural Niakhar (37%) than urban Dakar (30%), even after adjusting for age, sex and socio-economic status (difference=7%; 95%CI [1.1% to 13%]; p = 0.02). In Dakar, ownership of sheep was associated with greater risk (OR = 1.26; 95%CI[1.00-1.59]; p = 0.048). Livestock contact was associated with higher risk in rural areas, but not in urban areas (helping cattle’s parturition (OR = 2.10; 95%CI [1.38-3.22]; p &amp;lt; 0.01 and abortion (OR = 1.95; 95%CI[1.18-3.23]; p = 0.009). There was no association between dairy products’ consumption and Q-fever in both settings. Conclusions The high seroprevalence in urban and rural settings suggest that Q-fever should be seriously considered by clinicians when investigating fevers in both settings. The observed association with livestock contact is consistent with the lack of use of personal protection equipment. Key messages Clinicians should consider Q-fever among differential diagnosis when investigating non-specific fevers in West Africa.

1134Seroprevalence and Risk Factors of Coxiella burnetti infection in the general population of Senegal