Brucellosis in the Stavropol Territory: Results of 15-year follow-up of epidemiological and clinical features

Abstract

To analyze the epidemiological situation of brucellosis in the Stavropol Territory and to determine the specific features of its acute form. The epidemiological situation of brucellosis in the Stavropol Region was retrospectively analyzed using the 2000-2014 official statistics of the Russian Federation and Stavropol Territory for brucellosis cases, individual documents of the Russian Federal Service for Supervision of Consumer Rights Protection and Human Welfare Directorate in the Stavropol Territory and Russian Federation, and medical records of the Brucellosis Department, Stavropol Hospital Two. Brucellosis is a social problem in a group of focal zoonotic infections in the Russian Federation. In the North Caucasian Federal District, the largest number of new human brucellosis cases was notified in the Republic of Dagestan (59.3%) and Stavropol Territory (27.4%). The incidence of brucellosis in the Stavropol Territory was 5-10-fold higher than that in the Russian Federation as a whole. The true prevalence of brucellosis was 25% greater than the statistical data in terms of its clinical forms that were not included in official registration. Infection occurred in humans by contact with large and small cattle in 49.7% of cases. The disease mainly affected men (78.3%) and able-bodied people (67.7%); 78.5% of the patients seeking medical advice and as high as 79.9% of those being covered by serological examination of groups at risk for brucellosis were detected. There was a declining trend for the number of occupational brucellosis cases. At the same time, brucellosis accounted for 75% of the territory's total number of occupational diseases. In the past decade, brucellosis has exhibited a relatively benign course (91.3% for its moderate form), by predominantly involving the osteoarticular system (63%). Non-compliance with outpatient antibacterial therapy is one of the factors for brucellosis chronization. 28.2% of the patients who had undergone a complete therapy cycle developed chronic brucellosis less frequently (p < 0.005) than those who had stopped treatment for different reasons. Registration of brucellosis among humans is a result of the unfavorable epizootic situation of animal brucellosis. The highest incidence of brucellosis is observed in the northeastern areas of the Stavropol Territory, which border the Republic of Dagestan. The true prevalence of brucellosis greatly exceeds the official statistical data. Active detection of infection and timely diagnosis will be able to determine the real epidemic situation of brucellosis. Continuity of management and follow-up will provide a reduction in medical and social losses associated with this infection.