Risk Factors for Human Brucellosis in Northern Tanzania

Cash‐Goldwasser, Shama; Maze, Michael J.; Rubach, Matthew P.; Biggs, Holly M.; Stoddard, Robyn A.; Sharples, Katrina; Halliday, Jo E. B.; Cleaveland, Sarah; Shand, Mike; Mmbaga, Blandina T; Muiruri, Charles; Saganda, Wilbrod; Lwezaula, Bingileki F.; Kazwala, Rudovick; Maro, Venance P.; Crump, John A.

doi:10.4269/ajtmh.17-0125

Cited by 43 publications

(48 citation statements)

References 34 publications

(42 reference statements)

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“…We also show that boiling milk before consumption was strongly protective against brucellosis. This supports the findings of a number of other studies in East Africa showing either protective effects of boiling milk or increased risks with consuming it raw [8,11,24,44]. Health education messages that encourage safe milk preparation in the home could therefore also be expected to lead to a reduction in the incidence of brucellosis in Ijara.…”

Section: Plos Neglected Tropical Diseasessupporting

confidence: 84%

“…Large quantities of Brucella spp. can be shed in birth products of infected animals [9] and contact with these products has been reported as being important for brucellosis transmission in other settings in East Africa [11,44]. It is important to note that this exposure was relatively rare in this population, and therefore a failure to detect an effect here should not be taken as evidence for a lack of transmission of Brucella spp.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 88%

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Risk factors for acute human brucellosis in Ijara, north-eastern Kenya

et al. 2020

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Brucellosis is an important zoonotic disease globally, with particularly high burdens in pastoral settings. While the zoonotic transmission routes for Brucella spp. are well known, the relative importance of animal contact, food-handling and consumption practices can vary. Understanding the local epidemiology of human brucellosis is important for directing veterinary and public health interventions, as well as for informing clinical diagnostic decision making. We conducted a cross-sectional study in Ijara District Hospital, northeastern Kenya. A total of 386 individuals seeking care and reporting symptoms of febrile illness were recruited in 2011. Samples were tested for the presence of Brucella spp. using a real-time PCR (RT-PCR) and results compared to those from the test for brucellosis used at Ijara District Hospital, the febrile Brucella plate agglutination test (FBAT). A questionnaire was administered to all participants and risk factors for brucellosis identified using logistic regression with an information theoretic (IT) approach and least absolute shrinkage and selection (LASSO). Sixty individuals were RT-PCR positive, resulting in a prevalence of probable brucellosis of 15.4% (95% CI 12.0-19.5). The IT and LASSO approaches both identified consuming purchased milk as strongly associated with elevated risk and boiling milk before consumption strongly associated with reduced risk. There was no evidence that livestock keepers were at different risk of brucellosis than non-livestock keepers. The FBAT had poor diagnostic performance when compared to RT-PCR, with an estimated sensitivity of 36.6% (95% CI 24.6-50.1) and specificity of 69.3% (95% CI 64.0-74.3). Brucellosis is an important cause of febrile illness in northeastern Kenya. Promotion of pasteurisation of milk in the marketing chain and health messages encouraging the boiling of raw milk before consumption could be expected to lead to large reductions in the incidence of brucellosis in Ijara. This study supports the growing evidence that the FBAT performs very poorly in the diagnosis of brucellosis.

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Section: Plos Neglected Tropical Diseasessupporting

confidence: 84%

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 88%

Risk factors for acute human brucellosis in Ijara, north-eastern Kenya

et al. 2020

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“…People can get infected with brucellosis mainly through close contact with infected animals and consumption of contaminated meat, milk or dairy products. 2,3 Human brucellosis still poses great challenges to physicians such as the identification of markers for disease severity, progression, and treatment response, and the development of improved treatment regimens. 4 In China, human brucellosis has been classified as a notifiable infectious disease since 1955, the national incidence of human brucellosis had increased from 1.40/ 100,000 in 2005 to 4.22/100,000 in 2014 and then decreased slightly to 3.44/100,000 in 2016.…”

Section: Introductionmentioning

confidence: 99%

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

Liu¹,

Shen²,

Wei³

et al. 2020

IDR

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Purpose: To describe the incidence trend, demographic and clinical characteristics, treatment and prognosis, epidemiological history and risk factors of human brucellosis in Huludao, China. Patients and Methods: A total of 1887 brucellosis patients were reported in Huludao, China from January, 2014 to December, 2018 and the case questionnaires from 1149 patients were collected from Huludao Municipal Center for Disease Control and Prevention. Demographic characteristics of the patients and the information relating to the patients' clinical manifestations, diagnosis, treatment and prognosis were collected and analyzed. Results: The number of annually reported brucellosis patients has dropped from 711 to 187 during the study period, with the incidence decreased from 27.31/100,000 in 2014 to 7.15/ 100,000 in 2018. A total of 1149 individual data were collected, with a mean age of 49.59±13.14 years and 75.7% were male. Patients aged more than 60 years were more likely to have arthralgia/myalgia than the other age groups, and patients who had an enlarged spleen in male were more than female (P<0.05). There were more acute brucellosis cases, less sub-acute and chronic brucellosis cases in the ethnic minority (83.6%, 5.5% and 11.0%, respectively) than that in the Han nationality (64.7%, 22.2% and 13.0%, respectively, P<0.05). For antibiotic therapy, "Doxycycline plus rifampicin or streptomycin" was the most commonly used drug combination. Sheep/goat was the main contacted animal and feeding/grazing was the most frequent transmission route; no personal protective measures were the major risk factor. Conclusion: The incidence of human brucellosis is still high in Huludao, China, and this is mostly associated with contacting with domestic animals and barely taking protective measures. The most common clinical manifestations of brucellosis patients in Huludao were fatigue, hyperhidrosis, fever, and arthralgia/myalgia, the most common route of exposure was feeding and grazing, and the major species of livestock was sheep/goat. The most commonly adopted treatment option was antibiotic therapy, and most patients responded well to treatment. The integrality and accuracy of the notifiable epidemiological case questionnaire needs to be improved in order to provide more factual and objective information for both the physicians and policy-makers.

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“…Consuming boiled or pasteurised dairy products has been found to be protective against brucellosis. 8…”

Section: Reservoir Source and Mode Of Transmissionmentioning

confidence: 99%

Fever, bacterial zoonoses, and One Health in sub-Saharan Africa

2019

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Although often underappreciated, a number of bacterial zoonoses are endemic in Africa. Of these, brucellosis, leptospirosis, Q fever, and rickettsioses are responsible for a substantial proportion of febrile illness among patients seeking hospital care. In this paper, we discuss the aetiology, epidemiology, clinical presentation, diagnosis, treatment and prevention of these bacterial zoonoses. To prevent and control bacterial zoonoses, strategies targeting both animals and humans are crucial. These may lead to better outcomes than strategies based exclusively on treatment of human infections. Such strategies are referred to as the 'One Health' approach; the collaborative effort of multiple disciplines to attain optimal health for people, animals and the environment.

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Risk Factors for Human Brucellosis in Northern Tanzania

Cited by 43 publications

References 34 publications

Risk factors for acute human brucellosis in Ijara, north-eastern Kenya

Risk factors for acute human brucellosis in Ijara, north-eastern Kenya

<p>Analysis of the Epidemiological, Clinical Characteristics, Treatment and Prognosis of Human Brucellosis During 2014–2018 in Huludao, China</p>

Fever, bacterial zoonoses, and One Health in sub-Saharan Africa

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