Human brucellosis: sero-prevalence and associated risk factors in agro-pastoral communities of Kiboga District, Central Uganda

Abstract

BackgroundBrucellosis remains a neglected zoonotic disease among agro-pastoral communities where unprocessed milk and milk products are consumed. A cross-sectional study was carried out in Kiboga district to determine the seroprevalence and risk factors associated with human brucellosis in communities where livestock rearing in a common practice.MethodsA total of 235 participants were involved in the study. Blood samples from the participants were collected and screened for Brucella using Serum Agglutination Test and Rose Bengal Plate Test. A questionnaire was used to collect data on socio-demographic characteristics and human brucellosis related risk factors.ResultsHuman Brucella seroprevalence was at 17.0 % (n = 235). The prevalence was highest among males (20.5 %, n = 78) and the elderly - above 60 years (22.2 %, n = 18). Residence in rural areas (OR 3.16, 95 % CI: 1.16–8.56), consuming locally processed milk products (OR 2.54, 95 % CI: 1.12–5.78) and being single (OR 2.44, 95 % CI: 1.05–5.68), were associated with increased risk of brucellosis.DiscussionHuman brucellosis seroprevalence was high at 17 %, this was parallel with animal brucellosis prevalence that has been reported to range from 10.2 % to 25.7 % in cattle in the region. The participants were from communities known to habitually consume raw milk and milk products, know to process milk products using bare hands which are major risk factors for brucellosis in humans. This also explains why consumption of unpasteurized milk products was associated with the occurrence of brucellosis in study area. This strengthened the argument that humans get infected through consumption of contaminated animal products as reported in other earlier studies. Males and elderly being more affected because of traditional roles of these groups they play in livestock care and management. The single were also to be more associated to brucellosis, due to the fact that this group consume milk and milk products more as it is readily available in the informal markets as highly nutritious fast foods in this community as also observed in USA.ConclusionsBrucellosis is highly prevalent in Kiboga district, and therefore, an important public health problem. The transmission risk was aggravated by consumption of unpasteurized milk products, residing in rural settings and being single. There is a need to initiate screening, treat infected humans early, and educate the public about risk factors and appropriate preventive measures of brucellosis.

Epidemiological Investigation of Human Brucellosis in Pakistan

“…The result of the study elaborates (20.40%) prevalence in farmers as compared to other employers, which is in agreement with the findings of Shahid, who reported higher Brucella positivity in farmers (33%) and Tumwine (20.5%) and also coincides the fact that Brucella is more prominent in individuals, who kept animals at their homes and who had direct contact with animals (12,28). The possible grounds of such results are that rural residents and farmers are in close contact with animals, which act as a reservoir of brucellosis.…”

“…The individuals involved in milking and slaughtering of animals showed non statistically higher Brucella prevalence in this study (20% and 24%, respectively), yet some other studies also favoured this fact (12,29). On the other hand, these results are in contrast with the findings that slaughtering is a significant factor for Brucella prevalence (30).…”

“…In the present study the cumulative prevalence of Brucella was recorded as 16% from the study area, which was near the findings of 17% in Uganda (12) and 18% in Turkey (20). The observed prevalence was bit higher compared to previous studies conducted in Pakistan showing 9.33% and 10%, respectively (21,22).…”

“…Samples were collected using the non -probability convenience sampling technique (11). Expected prevalence was kept as 20%, as reported previously (12). A pre -designed questionnaire was administered to all participants to collect information about socio -demographic characters (gender, age, residence, marital status, occupation, education, religion, and presence of animals at home) and hypothesized factors (exposure to animals, milking, slaughtering, consuming milk products, and consuming raw milk) to detect their influence on spread and persistence of brucellosis.…”

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“…In another hand, [32] noticed that the prevalence of brucellosis in males (11.6%). higher than females (8.9%).Tumwine et al [35] in Uganda reported that the seroprevalence of human brucellosis varied among males (20.5 %, n=78) and females (15.3 %, n=157). Statistical analysis using ChiSquare showed no significant difference at the level of 0.05 for the brucellosis existing in the human where the value of Chi-Square was (0.42) with the level of significance 0.52 (p> 0.05).According to age groups, the prevalence rate of brucella antibodies among male was high in age group between 31-40 years (10.3 %), followed by the group with age between 21-30 years (10.0% ), then from 41 to 50 years were (7.1%),after that from 51 to 60 years were (6.9%), finally the age group from 11 to 20 years were (3.3 %) (Table2).The obtained results indicated that there were no significant differences between the RBT among male blood according to age (p>0.05).…”