Knowledge, attitudes and practices (KAPs) and risk factors of brucellosis at the human-animal interface in the Nile Delta, Egypt

Abstract

36 Background: Brucellosis is a highly contagious zoonosis affecting human and almost all domestic 37 species. It is a multi-burdens disease leading to severe economic losses due to disability in humans in 38 addition to abortion, infertility and reduced milk production in animals. An Important element for 39 effective prevention and control of brucellosis is to improve knowledge, attitude and practices of the 40 community. 41 Objective(s): This study aimed to assess the knowledge, attitudes and practices (KAP) related to 42 brucellosis at human-animal interface and to determine the risk factors for human infection in the 43 Nile Delta, Egypt.44 Methods: A matched case-control study was conducted at the main fever hospitals located in 6 45 governorates in the Nile Delta, Egypt between June 2014 and June 2016. Face-to-face interviews 46 with cases and controls was done using a structured questionnaire. Differences in proportions of 47 KAP variables among the cases and controls were evaluated by Pearson's Chi square test and a p 48 value <0.05 was set as a level of significance. A multivariate conditional logistic regression analysis 49 was built to determine the risk factors for Brucella spp. infection among study participants.50 Results: A total of 217 cases and 434 controls matched for age, gender and sociodemographic 51 characteristics were enrolled and interviewed. In total, 40.7% of the participants owned animals in 52 their households and lived in shared accommodation with animals [48.8% of cases vs 36.9% of 53 controls; (p= 0.003)]. The majority (78.1%) used to accommodate cows and buffaloes with sheep and 54 goats. Human brucellosis cases experienced more animal abortions comparing to the controls 55 [(23.5% vs 9.7%, respectively), (p= 0.0003)]. The majority of the participants (82.4%) did not notify 56 authorities in case that abortion occurs in their owned animals. Apparently, 67.4% of the 57 participants [(70.0% of the cases vs 66.1% of the controls) (p = 0.315)] had not ever heard about 58 brucellosis. The overall mean practice score regarding animal husbandry, processing and 59 consumption of milk and dairy products was significantly lower among cases comparing to controls (-60 12.7±18.1 vs 0.68±14.2 respectively; p< 0.0001). Perceived barrier for notification of animal infection 61 and/or abortion was significantly higher among cases (p= 0.034) and positively correlated with 62 participants' education. Results of univariate analysis showed that participants who have animals' 63 especially small ruminates were at a higher risk of getting Brucella spp. infection than others. In the 64 proposed multivariate conditional logistic regression model, the predictors of having brucellosis 65 infection were consumption of unpasteurized milk, having consumed dairy products in the last 3 66 months before the study, consumption of yoghurt or home-made cheeses and involvement in 67 contact with animals [OR (95% CI) = 4.12 (1.62 -10.75); 2.71 (1.06 -6.93); 2.51 (1.21 -5.24); 1.96 68 (1.17-3.30), p<0.05; and 4.97 (2....

Documenting the absence of bovine brucellosis in dairy cattle herds in the southern region of Malawi and the associated knowledge, attitudes and practices of farmers

“…In Tanzania, low knowledge, perception and practices towards brucellosis prevention were reported (Ntirandekura et al 2018 ). Another study carried out in Nile Delta, Egypt (Abd El-Wahab et al 2019 ) showed that more than two-thirds (67.4%) of the participants had not heard about brucellosis and in Rwanda 57.5% were unaware of brucellosis (Ndazigaruye et al 2018 ). In contrast to our findings, some studies on brucellosis knowledge reported a 100.0% awareness in Jordan (Musallam, Abo-Shehada & Guitian 2015 ) whilst 99.3% of the respondents had heard about brucellosis in Uganda (Kansiime et al 2015 ).…”

“…This is contrary to a study conducted in Kenya which recorded 96% raw milk consumption in a year (Obonyo & Gufu 2015 ). In another study conducted in Nile Delta, Egypt, drinking raw fresh milk was an uncommon practice owing to the awareness of associated hazards (Abd El-Wahab et al 2019 ). In this present study, the social-cultural practice was the main reason for low or no raw milk consumption.…”

Bovine brucellosis – a comprehensive review

“…Brucellosis may be transmitted from wild animals to domestic animals and ultimately to human beings (Cutler et al 2005 ). Moreover, a little knowledge on the disease and its transmission among livestock handlers negatively reflect their attitude and practice towards the disease control strategies (El-Wahab et al 2019 ).…”

“…Brucella species are among those pathogenic bacteria which have propensity to adapt to new host and they can either be naturally transmitted to their primary hosts by direct or indirect contact or sometimes inadvertently to other susceptible hosts (Moreno 2014 ). Mixed farming of cows, buffaloes, sheep and goats has increased the risk of brucellosis where small ruminants act as primary hosts for B. melitensis and cattle as spillover host (El-Wahab et al 2019 ). In India, brucellosis causes an average loss of US$18.2 per buffalo followed by 6.8 per cattle, 0.7 per sheep, 0.6 per pig and 0.5 per goat (Singh et al 2015 ).…”

Importance of brucellosis control programs of livestock on the improvement of one health

“…Several risk factors were identified including animal species, age, and pregnancy conditions as well as the occurrence of reproductive disorders. Furthermore, some environmental conditions, including milk storage and hygienic conditions, herd size, study area, and breeding approaches represent other key factors (Dadar et al 2019b;Deka et al 2018;El-Wahab et al 2019;Ness et al 2017;Ning et al 2013;Omer et al 2000;Proch et al 2018). However, the incidence of brucellosis in different hosts and countries is directly associated with eradication and control programs in livestock that should be implemented by national veterinary services such as vaccination and "test and slaughter" policy.…”