Brucellosis as a neglected disease in a neglected population: a seroepidemiological study of migratory nomads in the Fars province of Iran

Abstract

This study assessed the seroprevalence of brucellosis and its risk factors in migratory nomads in the Fars province of Iran. Active brucellosis was defined as the combination of clinical symptoms, including fever, chills, night sweats, headache, low back pain, arthralgia, or myalgia, and positive laboratory testing, including either a serum agglutination test (SAT) ⩾1:80 with a 2-mercaptoethanol (2-ME) test ⩾1:40, or a SAT <1:80 combined with a positive Coombs Wright test (CWT) at a titre of at least threefold higher than SAT titre results. For the 536 participants, the female (316, 59%) to male (220, 41%) ratio was 1·4 and the participants' mean age was 32·4 ± 18·9 (range 1-96) years. Of all participants, 325 (60·6%) showed clinical symptoms; in symptomatic participants, the Rose Bengal plate test was positive in 33 (6·1%) cases, the SAT was positive in 18 (3·3%) cases, and the 2-ME test was positive in 30 (5·5%) cases. Positive SAT and 2-ME results were seen in 18 (3·3%) cases, but a negative SAT and a positive CWT were found in 36 (6·7%) cases. As a result, active brucellosis was detected in 54 cases, indicating a prevalence of 10% (95% confidence interval 8-12). In conclusion, we determined that brucellosis is a prevalent yet neglected disease in this nomadic population. Brucellosis control is not possible as long as these high-risk populations remain neglected.

Epidemiological, Clinical and Paraclinical Evaluation of Recorded Cases with Brucellosis in Kermanshah Province Health Center 2012 - 2016

“…Of the 2714 patients studied, 55.3% were male, which is similar to most studies in the country (22,23) as well as other countries (Turkey (24), Saudi (25)). Contrary to the present study, in some studies conducted in Iran and in other countries, more than half of those infected are women (10,13,26). The mean age of the patients was 35.05 ± 17.35 years, similar to most national and international studies (13,23,27) (unlike one national study and one international study with a higher mean (8,10) and some other studies in and out of the country with a lower mean (9,24,25).…”

“…In the present study, the majority of patients were from rural and nomadic areas. Findings from other studies in many cases confirm this result, however, one study in Iran reported the majority of patients live in the city (23,26). The family history of patients in this study was 18.5% (34), which is almost in agreement with some other studies with 15% and 13%, and also consistent with another study (31) with 20%.…”

“…In studies out of Iran, Wright test was positive in 33 cases (41%). In a study in Fars province in Iran, 2ME test was positive in 30 cases (5.5%) (10,26). In the present study, the majority of patients were from rural and nomadic areas.…”

Brucellosis in the Middle East: Current situation and a pathway forward

“…These differences are attributed to demographic, occupational, and socioeconomic conditions [9]. Thus, it seems that the current disease status is much more complicated, specifically in rural areas with low socioeconomic situations [27][28][29][30] and among those with high-risk occupations [31].…”

Zagros Mountains: A region in Iran with extremely high incidence of Brucellosis

“…15 The high incidence of brucellosis in this area has many causes. 5,[16][17][18][19] Several studies have reported a higher density of livestock in these areas. The Zagros region has~43% of the total population (>34 million people) of Iran, and it is home to 52% of all livestock in the country, including cattle, sheep, and goats.…”