Epidemiology Of Human Brucellosis Research Articles

Epidemiology of human brucellosis in military hospitals in Jordan: A five-year study

Brucellosis is a zoonotic disease with significant impacts on livestock and human health. It is a severe community health burden in the Middle East with an estimated 2000 times higher prevalence than in North America and Western Europe. To date, there are limited studies on human brucellosis and risk factors for infection in Jordan. Our study aimed to analyze documented brucellosis cases in Jordan and use geographic and socio-demographic data to better understand its prevalence and transmission. This retrospective study examined electronic medical records describing 1,497 cases of febrile illness that were tested for brucellosis at Royal Medical Services hospitals between 2016 and 2020. A total of 465 confirmed brucellosis cases, aged 0 to 80 years were included. Serum samples were screened for anti-Brucella antibodies, and positive samples were additionally tested for antibody titer using the Wright tube agglutination test. Our results showed that 31.1% (456/1497) of the febrile diseases were brucellosis. We found that young adults and working age, northern governorates, rural location of residency, occupations involving regular contact with livestock, and Spring/Summer season were highly significant as risk factors. Seropositivity was highest among dairy factory workers with 64.4%. This study adds to our understanding of human brucellosis in Jordan and its impact on public health. These data will be useful in the prevention of brucellosis and will inform reliable disease control policies.

Epidemiological Study of the Brucellosis in Iran, Isfahan, 2010–2015

Background and aims: Brucellosis is one of the most common infectious diseases in both humans and animals. It has been controlled in developed countries; however, it is still regarded as a public health problem in developing countries including Iran. The aim of this study was to investigate the epidemiology of human brucellosis in Isfahan province. Methods: The present study is a cross-sectional descriptive study investigating the epidemiology of human brucellosis in Isfahan province from 2010 to 2015. Sampling was done using Isfahan’s disease registry database. Chi-square and t test were used for analyzing the data, and all data analyses were performed using SPSS software version 21.0. Results: A total of 3,245 patients were included in this study, and their mean (SD) age was 35.29 (18.00) years. The age group of 15-25 years with a frequency of 23.80% had the highest frequency of the disease. The annual incidence of the disease from 2010 to 2014 shows an increasing trend, reaching from 6.25 to 15 per 100000 people. It was reduced in 2015 and reached 12.25 per 100000. In addition, the highest incidence was observed in July. Conclusion: This study implies that the trend of human brucellosis has been increasing over the years, so it is recommended that people be educated on how to prevent it in humans and animals. The results of this study can help health administrators in the province to more effectively control the disease at the provincial level by identifying high-risk cities and focusing on health care in these areas.

Epidemiology of human brucellosis in Nahavand county, Hamadan Province, western Iran: an 8-year (2010-2017) registry-based analysis.

Brucellosis is an infectious zoonosis, which greatly afflicts human health and animal productivity. To describe the trends and epidemiological characteristics of human brucellosis in Nahavand county, Hamadan Province, western Iran over 8 years (2010-2017). In this registry-based longitudinal study, we analyzed all reported cases of human brucellosis, including 1,130 patients from 2010 to 2017. A checklist including demographic and clinical characteristics of patients with reported cases of brucellosis had been used to gather data. We calculated annual percent changes (APCs) and average annual percent changes (AAPCs) using Joinpoint software to determine the trend of brucellosis using a segmented regression model. Among the patients, 60.9% were male and 87.3% lived in rural areas. The mean age of the patients was 35.9 ± 18.34 years. Compared with male patients, female patients were more affected when they were elderly (15.6% men vs. 24.2% women for those aged ≥55 years) (P = 0.001). Of patients with brucellosis, 65.2% had consumed unpasteurized dairy products and 82.3% had a history of contact with animals. The incidence of human brucellosis in Nahavand county increased between 2010 and 2014, then decreased in 2015, and thereafter remained steady. Per 100,000 population, the AAPC pertaining to the incidence was 17.4 in the male population (95% CI: 4.4, 31.9), 13.8 in the female population (95% CI: 0.2, 29.3), and 16.1 in rural dwellers (95% CI: 2.2, 31.8) indicating an increasing trend from 2010 to 2017 (P < 0.05). The incidence of brucellosis in the western part of Iran is high and remains a challenging health problem. In the present study, age, job, sex, and seasonal changes are important risk factors for human brucellosis.

Time series and trend analysis of brucellosis in Oskou county, East Azerbaijan: 2007-2016.

Background: The epidemiology of human brucellosis has drastically changed in recent years. This study aims to assess trend in brucellosis in the Oskou county, East Azerbaijan, Iran. Methods: This cross-sectional study was conducted on all confirmed brucellosis cases over the period between 2007 and 2016 in Oskuo county. We use crude incidence rate (CIR) per100000 persons and carried out Joinpoint regression analysis to describe brucellosis trend over the study period. Also, we used ARIMA model to predict trend and number of new brucellosis cases for the coming years. Results: More than 90% (92.5%; 95% CI: 89.9-95.1) of brucellosis cases were in rural areas over the study period. In recorded cases, 60.5% (95% CI: 55.6-65.4) of total cases were men and 39.5% (95% CI: 34.6-44.4) of total cases were women. The mean age of men was 33.85(SD=19.72) years and the mean age of women was 35.88 (SD=17.26) years old. Majority of brucellosis cases occurred in spring. CIRs for the rural and urban areas were 47.62 to132.20 and zero to 18.55, respectively. The CIR for rural area had decreasing trend to 2011 and increasing for 2011-2017. Conclusion: Based-on time series analysis, the number of new cases in the future years has fixed trend and the most number of incident cases will be occurred between third to fifth months in each years.

Epidemiology of human brucellosis and source of Brucella isolates in Hunan province

Objective: To analyze the epidemiological characteristics of human brucellosis and trace back source of infection of human brucellosis in Hunan province during 2010-2018, and provide evidence for the prevention and control of human brucellosis. Methods: The surveillance data of human brucellosis in Hunan during 2010-2018 were analyzed with software Excel 2016 and ArcGIS 10.5, the epidemic characteristics were described using cases number, constituent ratio and rate. The conventional biotype methods were used for the identification of Brucella species, UTS-PCR was applied to further confirm the results from conventional biotype detections, then six virulence genes of two clinical Brucella strains were detected by PCR assay. Cluster analysis of two Brucella strains were performed with Multiple locus variable-number tandem repeat analysis (MLVA) for the investigation of the infection source of human brucellosis. Results: From 2010 to 2018, a total of 728 human brucellosis cases were reported in Hunan with the annual incidence rate of 0.12/100 000. The incidence rate was 2.50/100 000 in Chenzhou and 1.90/100 000 in Yongzhou, higher than those in other areas. The number of counties reporting cases increased from 5 in 2010 to 69 in 2018. Most cases were reported in age group 45-54 years, accounting for 38.32% (279/728). The cases in farmers accounted for 59.07% (430/728) of the total. The male to female ratio of the cases was 2.75 ∶ 1. The reported case number was highest during May-July, accounting for 45.33% (330/728). The incidence was high in summer and autumn, and the peak was in May. The conventional identification showed that two strains were all Brucella melitensis biovar 1, consistent with UTS-PCR amplification results. Six virulence genes were found in two isolated strains, suggesting that the Brucella melitensis strains in this study had strong virulence. MLVA results confirmed that two strains detected in Hunan had complete identical MLVA-16 genotype with strains isolated from goat and camel in Inner Mongolia Autonomous Region, indicating that there was molecular epidemiology relationship between these strains and the source of infection were originated from Inner Mongolia. Conclusions: The epidemic of human brucellosis in Hunan is becoming serious, and disease has spread to general population and non-epidemic areas. Two Brucella melitensis strains detected in Hunan were originated from Inner Mongolia. The quarantine and inspection in animal transportation should be strengthened to prevent human outbreaks of brucellosis.

Risk Factors for Human Brucellosis in Northern Tanzania.

.Little is known about the epidemiology of human brucellosis in sub-Saharan Africa. This hampers prevention and control efforts at the individual and population levels. To evaluate risk factors for brucellosis in northern Tanzania, we conducted a study of patients presenting with fever to two hospitals in Moshi, Tanzania. Serum taken at enrollment and at 4–6 week follow-up was tested by Brucella microagglutination test. Among participants with a clinically compatible illness, confirmed brucellosis cases were defined as having a ≥ 4-fold rise in agglutination titer between paired sera or a blood culture positive for Brucella spp., and probable brucellosis cases were defined as having a single reciprocal titer ≥ 160. Controls had reciprocal titers < 20 in paired sera. We collected demographic and clinical information and administered a risk factor questionnaire. Of 562 participants in the analysis, 50 (8.9%) had confirmed or probable brucellosis. Multivariable analysis showed that risk factors for brucellosis included assisting goat or sheep births (Odds ratio [OR] 5.9, 95% confidence interval [CI] 1.4, 24.6) and having contact with cattle (OR 1.2, 95% CI 1.0, 1.4). Consuming boiled or pasteurized dairy products was protective against brucellosis (OR 0.12, 95% CI 0.02, 0.93). No participants received a clinical diagnosis of brucellosis from their healthcare providers. The under-recognition of brucellosis by healthcare workers could be addressed with clinician education and better access to brucellosis diagnostic tests. Interventions focused on protecting livestock keepers, especially those who assist goat or sheep births, are needed.

وبائية حمة مالطا في البشر في محافظات العراق في سنة 2015

الخلاصة:: هو من الامراض التي تنتقل عن طريق الحيوانات الى الأنسان وهو مرض متوطن في كل انحاء العالم. المرض اكتشف في سنة 1937 في العراق عندما عزلت البكتريا المسببة للمرض بواسطة طبيب عراقي. الاهداف: لمعرفة عدد الاصابات بمرض حمة مالطا في محافظات العراق وعلاقة المرض بفصول السنة ومكان اقامة السكان وجنس وعمر المريض2- تشخيص مرض حمة مالطامن المرضى المتوقع اصابتهم بالمرض في محافظة بغداد بواسطة الاختبار السيرولوجي (اختبار روز بنكال) وطريقة الزرع. المرضى وطريقة العمل:&nbsp; لقد اجريت الدراسة في المستشفيات في مختلف محافظات العراق.حيث تم اخذ عينة دم (سيروم) من 1825 مريض من مختلف الأعمار بعد تسجيل تاريخ المريض وتشخيصه سريريا بأنه مصاب بالمرض. النتائج: خلال فترة الدراسة التي اجريت في محافظات العراق في سنة 2015 , 1825 مريض تم تشخيصهم سريريا و مختبريا بأنهم مصابين بمرض حمة مالطا. النتائج توضح ان الأصابة بالمرض اكثر شيوعا في النساء الريفيات وفي اشهر الصيف و في محافظات شمال العراق. لقد كانت نتيجة الأختبار السيرولوجي في محافظة بغداد موجبة في معظم الحالآت 71,3%&nbsp; بينما اختبار الزرع موجبة فقط 38,3% . الأستنتاج: النتائج تبين ان المرضى كانوا على اتصال بالحيوانات المصابة بالمرض ومنتجاتهم مثل الماعز والأغنام والماشية والأبقار في محافظات العراق.

Epidemiology of Human Brucellosis among Populations in Iraq's Provinces in 2015

Background: Brucellosis (Malta fever) is one of the zoonotic diseases that endemic in all the world, this disease has a history from 1937 in Iraq when the microorganism was first isolated via an Iraqi clinician.Objective: To demonstrate brucellosis infection among Iraqi provinces and reveal relationship between Brucellosis with seasons, residence place, gender and age of the patients. In addition to diagnosis of brucellosis from patients in Baghdad province suspects of infection by serological methods (Rose Bengal test) and culture method in diagnosis of brucellosis in human.Patients and Methods: This cross sectional study was conducted at Iraqi hospitals in different Iraqi provinces. The blood sample (serum) was obtained from 1825 patients from different age groups after reported the patient history and diagnosed clinically to have Malta fever.Results: During The study period in Iraqi provinces in 2015, One thousands and eight hundred twenty five patients were diagnosed clinically and serologically to have brucellosis infection. The infection is more predominant in rural females in the months of summer and among Iraqi Kurdistan people. In Baghdad regions the serologic test was positive in most cases (71.3%) while only 38.3% were positive for Brucella culture.Conclusion: Our results indicate that patients were contact with infected livestock or suspected infection of Brucella like: goat, sheep, cow and buffalo located in epidemiological regions in Iraq province across the study period .

Human Brucellosis Trends: Re-emergence and Prospects for Control Using a One Health Approach in Azerbaijan (1983-2009).

Brucellosis is one of the most common and widely spread zoonotic diseases in the world. Control of the disease in humans is dependent upon limiting the infection in animals through surveillance and vaccination. Given the dramatic economic and political changes that have taken place in the former Soviet Union, which have limited control, evaluating the status of human brucellosis in former Soviet states is crucial. We assessed annual spatial and temporal trends in the epidemiology of human brucellosis in Azerbaijan, 1983-2009, in conjunction with data from a livestock surveillance and control programme (2002-2009). To analyse trends, we used a combination of segmented regression and spatial analysis. From 1983 to 2009, a total of 11233 cases of human brucellosis were reported. Up to the mid-1990s, the incidence of human brucellosis showed a pattern of re-emergence, increasing by 25% annually, on average. Following Soviet governance, the incidence rates peaked, increasing by 1.8% annually, on average, and subsequently decreasing by 5% annually, on average, during the period 2002-2009. Despite recent national declines in human incidence, we identified geographic changes in the case distribution characterized by a geographic expansion and an increasing incidence among districts clustered in the south-east, compared to a decrease of elsewhere in the country. Males were consistently, disproportionately afflicted (71%) and incidence was highest in the 15 to 19 age group (18.1 cases/100000). During the period 2002-2009, >10 million small ruminants were vaccinated with Rev1. Our findings highlight the improving prospects for human brucellosis control following livestock vaccination; however, the disease appears to be re-emerging in south-eastern Azerbaijan. Sustained one health measures are needed to address changing patterns of brucellosis in Azerbaijan and elsewhere in the former Soviet Union.

Increasing Incidence of Human Brucellosis in Southern Israel after the Cessation of a Veterinarian Control Campaign

The southern region of Israel is populated by a mostly urban Jewish majority (population: 385,200 inhabitants) and a large seminomadic Bedouin minority (population: 188,900) who maintains herds of sheep and goats. A retrospective study was conducted to assess the impact of the 1997 decision to discontinue a veterinarian control campaign on the epidemiology of human brucellosis in the region.

Ovine and caprine brucellosis ( Brucella melitensis ).

Abstract Brucellosis, caused by Brucella melitensis , remains one of the most common zoonotic diseases worldwide with more than 500 000 human cases reported annually. The bacterial pathogen is classified, by the US Centers for Disease Control (CDC), as a category (B) pathogen and belongs to the World Organisation for Animal Health (OIE) list B diseases. Brucella melitensis , the first species in the genus Brucella to be described, causes abortions in female goats and sheep, unilateral orchitis in males and Malta fever in humans. The natural hosts may be goats and sheep, but the organism is the least species-specific of the brucellae. B. melitensis biovars 1 and 3 are the most frequently isolated in Mediterranean countries. In most circumstances, the primary excretion sources are foetal fluids, vaginal discharges after abortion or full-term parturition, in milk and semen. The epidemiology of human brucellosis has drastically changed over the past decade because of various sanitary, socio-economic and political reasons, together with the evolution of international travel. Besides the public health concern of such an important zoonosis, Brucella infections in animals have an important economic impact especially in developing countries as they cause abortion in pregnant animals, reduce milk production and cause fertility problems. The most reliable and the only unequivocal method for diagnosing animal brucellosis is the isolation of Brucella spp., but polymerase chain reaction (PCR) has the potential to meet the need for better diagnostic tools. It is highly sensitive, very specific, inexpensive and easily adapted to high-volume demands. The process is rapid, simple and requires little manual labour. A sensitive and dependable diagnostic PCR assay for B. melitensis is crucial for controlling the spread of Brucella in animal and human population. Immunological testing for brucellosis among livestock is usually conducted as a component of the disease eradication and surveillance programme rather than as diagnostic support and each country has a different policy for testing livestock. The serological tests commonly used for the diagnosis of B. melitensis infection are the Rose Bengal Test (RBT), Serum Agglutination Test (SAT), Complement Fixation Test (CFT) and enzyme-linked immunosorbent assays (ELISA). The RBT and CFT are the most widely used tests for the serological diagnosis of sheep and goat brucellosis; they are also the official tests for international trade. B. melitensis infection is particularly problematic, because Brucella abortus vaccines do not protect effectively against B. melitensis infection. In regions with a high prevalence of the disease, the only way of controlling and reducing the prevalence of zoonosis is by the vaccination of all susceptible hosts and elimination of infected animals. B. melitensis strain Rev-1, although highly infectious to humans, is considered as the only vaccine available for the control of ovine and caprine brucellosis, especially when administrated at the standard dose by the conjunctival route. However, the Rev-1 vaccine shows a considerable degree of virulence and induces abortions when administered during pregnancy. Also, the antibody response to vaccination cannot be differentiated from the one observed after field infection, which impedes control programmes. Attempts have been made to develop new live attenuated rough B. melitensis vaccines, which are devoid of the O-side chain. Those vaccines await further evaluation in field experiments. The aetiology, isolation, epidemiology, global distributions and new methods of diagnosis and control programmes for ovine and caprine brucellosis have been reviewed in this article.

Rapid Diagnosis of Brucella Epididymo-Orchitis by Real-Time Polymerase Chain Reaction Assay in Urine Samples

We studied the diagnostic yield of a real-time polymerase chain reaction assay in urine samples for the rapid diagnosis of brucella epididymo-orchitis compared to that of conventional microbiological techniques. We used an SYBR Green I LightCycler based real-time polymerase chain reaction to retrospectively study 10 urine samples from patients with Brucella epididymo-orchitis. The assay amplifies a 223 bp sequence of a gene that codes for the synthesis of an immunogenetic membrane protein specific for Brucella genus (BCSP31). After amplifying this 223 bp sequence we performed melting curve analysis to verify the specificity of polymerase chain reaction products. Brucella melitensis was isolated from blood cultures in 9 cases (90%). Wright's seroagglutination was negative or inconclusive in 30% of cases. Brucella was isolated from urine in only 1 case, whereas real-time polymerase chain reaction assay in urine was positive in 9 (90%). Also, results were available in 4 hours, whereas mean time to availability of the final blood culture results was 5.8 days (range 4.5 to 7). SYBR Green I LightCycler based real-time polymerase chain reaction assay in urine samples is highly sensitive and specific, and easy to perform. It could provide the clinician with results in less than 5 hours. The technique could be a practical and useful tool for the rapid diagnosis of genitourinary complications of human brucellosis.

Epidemiology of human brucellosis in a defined area of Northwestern Greece

Despite a European co-financial programme for control and eradication of brucellosis in Southern Europe, there is evidence that foci of brucellosis still exists in Greece and other Southern European countries. Human brucellosis cases are probably underreported in these countries. A local surveillance system was implemented in a defined region of Northwestern Greece, in order to record and study all human brucellosis cases, using several sources of retrieval. A total of 152 newly diagnosed cases were recorded during a 2-year study period (from 1 April 2002 to 31 March 2004). The age- and sex-adjusted mean annual incidence rate for the population of the study area was 17.3 cases/10(5) inhabitants. Incomplete application of the control and eradication programme in livestock, and the possible illegal trafficking of animals and their products across the Greek-Albanian border could be responsible for the persistence of foci of brucellosis in the area.

Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece.

A case-control study was conducted in a rural area of Achaia in western Greece to examine the risk factors of brucellosis. The participants in the study were 414 (7.5% of the whole population of the investigated municipality). The cases (n = 140) were defined by clinical symptoms and confirmed by a positive standard agglutination test (SAT). All cases have been diagnosed between January 1997 and March 1999 either by physicians of the Local Health Center or by private practitioners. Two criteria were basic to establish the disease. The first one was clinical symptoms such as fever, fatigue, arthralgia and generalized aches and the second was a titer of SAT at least 1:160. Controls (n = 274) were matched with cases for age and gender in a 1:2 ratio. Approximately collection of controls was performed among those presented to the local Health Center for other diseases. Data were collected by the same physician via a personal interview and analyzed by logistic regression models. The overall incidence of the disease in the region was found to be 1110/100,000. Taking 'no ownership of animals' and 'no contact of animals' as the reference category, the strongest risk factor was trauma during animal delivery with an odds ratio (OR): 24.3; 95% confidence interval (CI): 8.8-67.5 following by absence of stables (OR: 14.4; 95% CI: 4.7-44.1). After application of multivariate stepwise analysis the adjusted risk factors remaining in the model were the place of residence (OR: 1.8; 95% CI: 1.1-3.1), professional occupation with animals (OR: 2.4; 95% CI: 1.2-4.8), absence of stables (OR: 9.1; 95% CI: 2.2-38.7) and trauma during animal delivery (OR: 11.2; 95% CI: 3.2-39.1). Consumption of cheese from pasteurized milk or consumption of cheese matured for over 3 months was found to be a protective factor (OR: 0.27; 95% CI: 0.11-0.67). The detection of brucellosis in animals is essential for the prevention of the disease. In addition efficient preventive measures should be established in order to eliminate the disease.

Epidemiology of human brucellosis in Lebanon in 1997

Summary Objective The authors wanted to identify the epidemiological features of brucellosis in Lebanon. This study was carried out from January 1, 1997 to December 31, 1997. Methods The authors used a descriptive analysis of surveillance data for all new cases of brucellosis reported to the Epidemiological Surveillance Unit of the Department of Preventive Medicine at the Ministry of Public Health in Lebanon. Results The brucellosis incidence rate was 8.1 per 100,000 people in Lebanon, with no gender difference. Low incidence rates were confined to patients under 15 years of age. The monthly distribution of brucellosis cases demonstrated maximal rates in the spring and summer months, suggesting a strong connection to the lambing season. Conclusions The results of this study shows the endemicity of brucellosis in Lebanon. The only effective way to control the disease in man is the elimination of infected animals and the vaccination of healthy ones, in order to produce brucellosis-free animal products.

Brucellosis in Saudi Arabia: Past, Present and Future

Brucellosis in Saudi Arabia: Past, Present and Future

Epidemiology of human brucellosis in the United Kingdom.

Epidemiology of human brucellosis in the United Kingdom.