Factors Associated With Diagnostic Delays in Human Brucellosis in Tongliao City, Inner Mongolia Autonomous Region, China

Zhai, Jingbo; Peng, Ruihao; Wang, Ying; Lu, Yuying; Yi, Huaimin; Liu, Jinling; Lu, Jiahai; Chen, Zeliang

doi:10.3389/fpubh.2021.648054

Cited by 10 publications

(5 citation statements)

References 29 publications

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“…The slow growth of Brucella in primary cultures delays diagnosis. Therefore, serological tests play a major role in the routine diagnosis of brucellosis [27] , [43] . This was evident in our study when the initial 54 blood cultures of symptomatic patients showed no growth.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of brucellosis among animal handlers in West Bengal, India: an occupational health study

Modak,

Biswas,

Mondal

et al. 2024

AIMSMICRO

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<abstract> <p>Brucellosis is a highly contagious zoonotic disease and a major human health problem worldwide. Due to its ways of transmission, direct or indirect contact with infected animals or their contaminated biological products, the disease exhibits strong occupational association with animal handlers comprising a significant population at risk. This study was undertaken to estimate the seroprevalence of brucellosis in animal handlers and to understand the epidemiological and serological aspects of the same. The animal handlers from the state of West Bengal, India were included in this study. It was a prospective and observational cohort study from November 2021 to March 2022. A total of 669 sera samples were collected from animal handlers and tested using various serological tests for <italic>Brucella</italic> antibodies. All serum samples were tested using the Rose Bengal plate test (RBPT), standard tube agglutination test (STAT), and enzyme-linked immunosorbent assay (ELISA). 106 (15.8%) patients were diagnosed with brucellosis among the total number of patients tested. Most of the patients affected with brucellosis belonged to the age group 51–60 years (23.5%). The seropositivity rate in male animal handlers was higher than female animal handlers in this study. More studies are needed to understand the occupational association of this disease. Awareness programs, safe livestock practices, and prevention of the disease by timely diagnosis must be implemented in order to control human brucellosis.</p> </abstract>

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Section: Discussionmentioning

confidence: 99%

Seroprevalence of brucellosis among animal handlers in West Bengal, India: an occupational health study

Modak,

Biswas,

Mondal

et al. 2024

AIMSMICRO

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“…Restrictions and screening of travelers, especially with fever and similar symptoms, likely reduced the number of nonlocal cases visiting Xi'an for treatment (36). Additionally, shorter HB-diagnostic delays were observed at CDC agencies probably because of their better laboratory testing capabilities, which underlies their significance in the prevention and control of infectious diseases (24).…”

Section: Discussionmentioning

confidence: 99%

“…Farmers, herdsmen, and abattoir workers were classified as rural workers, while other occupations such as healthcare workers, students, and teachers were defined as non-rural workers. Diagnostic delays were defined as the time interval between the onset of HB symptoms noted by the patient and its confirmed diagnosis at a healthcare institution (24).…”

Section: Human Brucellosismentioning

confidence: 99%

Epidemic characteristics and transmission risk prediction of brucellosis in Xi'an city, Northwest China

Zhao

Liu

Jiang

et al. 2022

Front. Public Health

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Human brucellosis (HB) has re-emerged in China since the mid-1990s, and exhibited an apparent geographic expansion shifted from the traditional livestock regions to the inland areas of China. It is often neglected in non-traditional epidemic areas, posing a serious threat to public health in big cities. We carried out a retrospective epidemiological study in Xi'an, the largest city in northwestern China. It utilizes long-term surveillance data on HB during 2008–2021 and investigation data during 2014–2021. A total of 1989 HB cases were reported in Xi'an, consisting of 505 local cases, i.e., those located in Xi'an and 1,484 non-local cases, i.e., those located in other cities. Significantly epidemiological heterogeneity was observed between them, mainly owing to differences in the gender, occupation, diagnostic delays, and reporting institutions. Serological investigations suggested that 59 people and 1,822 animals (sheep, cattle, and cows) tested positive for brucellosis from 2014 to 2021, with the annual average seroprevalence rates were 1.38 and 1.54%, respectively. The annual animal seroprevalence rate was positively correlated with the annual incidence of non-local HB cases. Multivariate boosted regression tree models revealed that gross domestic product, population density, length of township roads, number of farms, and nighttime lights substantially contributed to the spatial distribution of local HB. Approximately 7.84 million people inhabited the potential infection risk zones in Xi'an. Our study highlights the reemergence of HB in non-epidemic areas and provides a baseline for large and medium-sized cities to identify regions, where prevention and control efforts should be prioritized in the future.

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“…Although it is rarely fatal, diagnostic challenges such as nonspecific clinical signs and slow growth in culture specimens, which result in a delayed diagnosis, lead to severe disabilities. 11 Therefore, the objective of this study was to establish the frequency, clinical manifestations, and para-clinical characteristics of brucellar arthritis and sacroiliitis in patients presenting to a referral hospital in the west of Iran.…”

Section: Introductionmentioning

confidence: 99%

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

Morovati,

Bozorgomid,

Mohammadi

et al. 2024

Therapeutic Advances in Infection

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Introduction: Brucellosis is a common global zoonotic disease with a wide range of complex and nonspecific clinical manifestations that may lead to misdiagnosis and delayed treatment. Osteoarticular involvement is the most common complaint in brucellosis. Objective: This present study aims to describe the clinical and laboratory characteristics and treatment of brucellosis patients with arthritis and sacroiliitis. Methods: This retrospective descriptive study was performed on patients presenting to a teaching hospital in Kermanshah, Iran with a diagnosis of brucellosis from 2011 to 2019. The demographic and clinical characteristics, complications, laboratory findings, and treatment were recorded during the study period. Then, the difference in the collected data was investigated between brucellosis patients with and without arthritis or sacroiliitis. Results: Of 425 patients studied, 130 (30.58%) had osteoarticular involvement. Among them, 41 (9.64%) and 58 (13.6%) patients were diagnosed with arthritis and sacroiliitis, respectively. There were no significant demographic differences between patients with and without brucellar arthritis or sacroiliitis ( p > 0.05). The patients with Brucella arthritis had a significantly higher frequency of arthralgia and radiculopathy ( p ⩽ 0.05). Sacroiliitis was significantly more common in patients with arthralgia, neck pain, and low back pain, positive flexion-abduction-external rotation (FABER) test, radiculopathy, and vertebral tenderness compared to patients without sacroiliitis ( p ⩽ 0.05), while fever and headache were significantly more common in patients without sacroiliitis ( p ⩽ 0.05). The median Wright and 2-Mercapto Ethanol titers were higher in brucellosis patients with arthritis or sacroiliitis versus patients without arthritis or sacroiliitis, but the difference was not significant ( p > 0.05). Synovial fluid had been analyzed in 20 cases. The mean white blood cell count, glucose, and protein level were 3461 ± 2.70 cells/mm3, 58.54 ± 31.43 mg/dL, and 8.6 ± 11.85 g/dL, respectively. In 80% of the subjects, neutrophil cells were predominant. There were no significant laboratory differences between patients with and without brucellar arthritis or sacroiliitis, except for a higher median platelet count in patients with arthritis and higher median levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) in patients with sacroiliitis. Most cases of arthritis and sacroiliitis were diagnosed with ultrasound (31.8%) and FABER test (79.3%), respectively. Conclusion: Arthritis and sacroiliitis were the two most important and common manifestations of brucellar osteoarthritis with a frequency of 9.64% and 13.6%, respectively. Any complaints of low back pain and radiculopathy as well as the presence of spondylitis in patients should raise suspicion of sacroiliitis. High levels of AST and ALP and a high platelet count may be associated with brucellar sacroiliitis and arthritis, respectively. The use of imaging methods such as MRI and bone scan seems necessary for the diagnosis of sacroiliitis.

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Factors Associated With Diagnostic Delays in Human Brucellosis in Tongliao City, Inner Mongolia Autonomous Region, China

Cited by 10 publications

References 29 publications

Seroprevalence of brucellosis among animal handlers in West Bengal, India: an occupational health study

Seroprevalence of brucellosis among animal handlers in West Bengal, India: an occupational health study

Epidemic characteristics and transmission risk prediction of brucellosis in Xi'an city, Northwest China

Brucellar arthritis and sacroiliitis: an 8-year retrospective comparative analysis of demographic, clinical, and paraclinical features

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