Risk Factors and Diagnostic Criteria of Brucellosis in an Endemic Area in Egypt

Abstract

A case-control study was conducted during the year 2003 in Tanta Fever Hospital within an endemic area for brucellosis (Br) in Egypt. One hundred forty-nine cases of Br and 298 patients with other infectious diseases wereconsecutively enrolled. Risk factors of Br (adjusted odds ratio) were having sheep (6.2 folds), high-risk occupation such as farmers and butchers (4.5 folds), having an aborted animal (3.5 folds), and increasing age (1.04 fold per year). Previous admission into a fever hospital within a year (6.5 folds), arthritis (2.9 folds), and positive C-reactive protein (1.1 fold) were significant predictors for Br. Rose bengal panel test showed 100% performance agreement with tube agglutination test for diagnosis of Br. Adding 2-mercaptoethanol to tube agglutination test did not increase its sensitivity or specificity for acute Br; neither did Coombs test. In conclusion, laboratory confirmation by tube agglutination test that should be preceded by rose bengal panel test as a screening test is absolute requirement for diagnosis of Br. Considering the previously mentioned risk factors could be useful in developing an algorithm for diagnosis of Br, particularly among those with atypical clinical presentation.