Human Brucellosis, a Heterogeneously Distributed, Delayed, and Misdiagnosed Disease in China

Wang, Yufei; Zhang, Wenyi; Yuan, Ke; Zhen, Qing; Yuan, Xitong; Zou, Wen; Li, Shenlong; Sun, Yan; Wang, Zhonghai; Wang, Dali; Cui, Buyun; Song, Hongbin; Huang, Liuyu; Chen, Zeliang

doi:10.1093/cid/cis980

Cited by 34 publications

(36 citation statements)

References 7 publications

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“…However, almost half of patients had delayed diagnosis, thereby missing the optimal treatment windows [49] and increasing the risk of developing chronic brucellosis. Chronic disease would cause greater economic loss and health harm [50–52] for affected individuals and their families, even the whole society. Launching awareness campaigns before the epidemic season may be effective to prevent the risk group from infection and promote them to seek timely treatment when infected.…”

Section: Discussionmentioning

confidence: 99%

Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

et al. 2016

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BackgroundBrucellosis, one of the world’s most important zoonosis, has been re-emerging in China. Shanxi Province, located in northern China, where husbandry development has been accelerated in recent years, has a rather high incidence of human brucellosis but drew little attention from the researchers. This study aimed to describe the changing epidemiology of human brucellosis in Shanxi Province from 2005 to 2014 and explore high-risk towns and space-time clusters for elucidating the necessity of decentralizing disease control resource to township level in epidemic regions, particularly in hotspot areas.MethodsWe extracted data from the Chinese National Notifiable Infectious Disease Reporting System to describe the incidence and spatiotemporal distribution of human brucellosis in Shanxi Province. Geographic information system was used to identify townships at high risk for the disease. Space-Time Scan Statistic was applied to detect the space-time clusters of human brucellosis during the past decade.ResultsFrom 2005 to 2014, a total of 50,002 cases of human brucellosis were recorded in Shanxi, with a male-to-female ratio of 3.9:1. The reported incidence rate increased dramatically from 7.0/100,000 in 2005 to 23.5/100,000 in 2014, with an average annual increase of 14.5%. There were still 33.8% cases delaying diagnosis in 2014. The proportion of the affected towns increased from 31.5% in 2005 to 82.5% in 2014. High-risk towns spread from the north to the center and then south of Shanxi Province, which were basins and adjacent highlands suitable for livestock cultivation. During the past decade, there were 55 space-time clusters of human brucellosis detected in high risk towns; the clusters could happen in any season. Some clusters’ location maintained stable over time.ConclusionsDuring the last decade, Shanxi province’s human brucellosis epidemic had been aggravated and high-risk areas concentrated in some towns located in basins and adjacent highlands. Space-time clusters existed and some located steadily over time. Quite a few cases still missed timely diagnosis. Greater resources should be allocated and decentralized to mitigate the momentum of rise and improve the accessibility of prompt diagnosis treatment in the high-risk townships.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2086-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

et al. 2016

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“…As live animals and raw products from Brucella ‐endemic areas are frequently transported across the whole country, cases of brucellosis are recorded in all regions of China . In Saudi Arabia, the incidence of Brucella infection is particularly high around the city of Riyadh.…”

Section: Discussionmentioning

confidence: 99%

“…As live animals and raw products from Brucellaendemic areas are frequently transported across the whole country, cases of brucellosis are recorded in all regions of China. 34,[37][38][39] In Saudi Arabia, the incidence of Brucella infection is particularly high around the city of Riyadh. The majority (82%) of acute febrile illnesses of unknown cause were confirmed Brucella positive, 72% carrying detectable Brucella DNA in the Northern region.…”

Section: Discussionmentioning

confidence: 99%

Potential risk of blood transfusion‐transmitted brucellosis in an endemic area of China

Wang

Liao

et al. 2014

Transfusion

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“…From this study in Chad, an incidence of 35 cases per 100 000 person-years was derived from a seroprevalence of 3.8%, assuming a fixed proportion of clinical cases among seropositives (10%) and a fixed duration of seropositivity [38 ▪▪ ]. Robust disease incidence data are lacking in other regions of the world as well: whereas seroprevalence studies in China and Korea indicate brucellosis is endemic in some regions [40–42], we are unaware of incidence estimates in East Asia.…”

Section: Epidemiology Of Human Brucellosismentioning

confidence: 99%

Brucellosis in low-income and middle-income countries

Rubach

Halliday

Cleaveland

et al. 2013

Current Opinion in Infectious Diseases

200

176

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Purpose of review Human brucellosis is a neglected, underrecognized infection of widespread geographic distribution. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. This review describes new information regarding the epidemiology of brucellosis in the developing world and advances in diagnosis and treatment. Recent findings The highest recorded incidence of human brucellosis occurs in the Middle East and Central Asia. Fever etiology studies demonstrate brucellosis as a cause of undifferentiated febrile illness in the developing world. Brucellosis is a rare cause of fever among returning travelers, but is more common among travelers returning from the Middle East and North Africa. Sensitive and specific rapid diagnostic tests appropriate for resource-limited settings have been validated. Randomized controlled trials demonstrate that optimal treatment for human brucellosis consists of doxycycline and an aminoglycoside. Decreasing the burden of human brucellosis requires control of animal brucellosis, but evidence to inform the design of control programs in the developing world is needed. Summary Brucellosis causes substantial morbidity in human and animal populations. While improvements in diagnostic options for resource-limited settings and stronger evidence for optimal therapy should enhance identification and treatment of human brucellosis, prevention of human disease through control in animals remains paramount.

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Human Brucellosis, a Heterogeneously Distributed, Delayed, and Misdiagnosed Disease in China

Cited by 34 publications

References 7 publications

Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

Epidemic characteristics, high-risk townships and space-time clusters of human brucellosis in Shanxi Province of China, 2005–2014

Potential risk of blood transfusion‐transmitted brucellosis in an endemic area of China

Brucellosis in low-income and middle-income countries

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