SummaryThis study aimed at assessing the epidemiology of brucellosis among both human and livestock populations in an endemic area in Egypt. A cross-sectional survey was conducted in two villages, where 616 inhabitants (aged 3-75 years) and 350 livestock of 97 households were enrolled. Sera were tested for Brucella spp. antibodies by tube agglutination test for both populations. Proportions of seropositive sera were 0.0 and 1.7% among the inhabitants, and 0.0 and 16% among livestock of villages I and II, respectively. Calculated seroprevalences considering the clustering of brucellosis within households were 0.03 for people and 5.2 for livestock in village II. The village variable (P = 0.07) and keeping sheep in the household (P = 0.01) were significant risk factors for human brucellosis, whereas only the village was significant for livestock (P < 0.001). Sheep showed the highest seropositive proportions of brucellosis among livestock. No association could be detected between human and livestock brucellosis. In conclusion, we found local variation of seroprevalences of brucellosis among human and livestock in the two surveyed villages. Further epidemiological studies have to be conducted in randomly selected governorates, not only to confirm the low seroprevelance of human brucellosis, but also to assess the risk factors of livestock infection for terms of prophylaxis.
A case-control study was conducted during the year 2003 in Tanta Fever Hospital within an endemic area for brucellosis (Br) in Egypt. One hundred forty-nine cases of Br and 298 patients with other infectious diseases were consecutively enrolled. Risk factors of Br (adjusted odds ratio) were having sheep (6.2 folds), high-risk occupation such as farmers and butchers (4.5 folds), having an aborted animal (3.5 folds), and increasing age (1.04 fold per year). Previous admission into a fever hospital within a year (6.5 folds), arthritis (2.9 folds), and positive C-reactive protein (1.1 fold) were significant predictors for Br. Rose bengal panel test showed 100% performance agreement with tube agglutination test for diagnosis of Br. Adding 2-mercaptoethanol to tube agglutination test did not increase its sensitivity or specificity for acute Br; neither did Coombs test. In conclusion, laboratory confirmation by tube agglutination test that should be preceded by rose bengal panel test as a screening test is absolute requirement for diagnosis of Br. Considering the previously mentioned risk factors could be useful in developing an algorithm for diagnosis of Br, particularly among those with atypical clinical presentation. (Infect Dis Clin Pract 2005;13:295-299)B rucellosis (Br) is the leading zoonotic disease in the Eastern Mediterranean Region and is of major concern in view of its impact on both public health and animal production scheme. 1 In Egypt, the estimated annual economic losses attributed to Br accounted for US$10 million during the early 1990s. 2 Infection in man is often both a food-borne as well as an occupational-related disease in addition to environmental factors. 3 A definitive diagnosis of Br is based on culture of Brucella strains from different samples, mainly blood. 4 Due to many obstacles with culture, diagnosis relies mainly on serology, particularly the standard tube agglutination test (TAT). 5 Tanta Fever Hospital is a major hospital for infectious diseases in the capital of Gharbia Governorate. An increasing rate of admission of Br was noticed among patients with specific fevers from 3% in 1993 to 13% in 2002. 6 Moreover, Gharbia Governorate was one of the most active governorates in Egypt that report laboratory-confirmed Br in relation to total population. 7 The aim of this study was to identify risk factors which contributed to Br in our community and, eventually, establish an integrated system for its control. The study also aimed at evaluating the diagnostic performance of rose bengal panel test (RBPT) in comparison to the standard TAT and some tests routinely used in Eastern Mediterranean Region countries to promote a reliable protocol for diagnosis of Br.
SUBJECTS AND METHODS
Technical DesignA case-control study was conducted in Tanta Fever Hospital. Cases were patients admitted with Br during a calendar year to cover seasonal variations. Patients diagnosed by clinical features such as fever of more than 7 days' duration, bone ache ± arthralgia, positive serological tests for Br (RBPT an...
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