Year: 2017
Type: article
Study design: Observational Study
Abstract: 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.
Authors: Shama Cash-Goldwasser, Michael J. Maze, Matthew P. Rubach, Holly M. Biggs, Robyn A. Stoddard, Katrina J. Sharples, Jo E. B. Halliday, Sarah Cleaveland, Michael C. Shand, Blandina T. Mmbaga, Charles Muiruri, Wilbrod Saganda, Bingileki F. Lwezaula, Rudovick R. Kazwala, Venance P. Maro, John A. Crump
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Estimated APC paid: $2,813
Funders: National Science Foundation, U.S. Department of Health and Human Services, Bill and Melinda Gates Foundation, University of Otago, Research Councils UK, University of Glasgow, National Institutes of Health, Centers for Disease Control and Prevention, Directorate for Biological Sciences, Duke Global Health Institute, Duke University, Defence Science and Technology Laboratory, Biotechnology and Biological Sciences Research Council, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, Fogarty International Center
Awards: Viral Zoonoses and Severe Febrile Illness in Northern Tanzania, G1616524148, Social, Economic and Environmental Drivers of Zoonoses in Tanzania (SEEDZ), Hazards Associated with Zoonotic enteric pathogens in Emerging Livestock meat pathways (HAZEL), G1894086871, The impact and social ecology of bacterial zoonoses in northern Tanzania, G3414247287, G3707093193, G396838351, Vanderbilt-Emory-Cornell-Duke Consortium for Global Health Fellows (VECDor), The Impact and Society Ecology of Bacterial Zoonoses in Northern Tanzania: Under, G5522424963, Molecular epidemiology of brucellosis in northern Tanzania, International Vaccine Institute - to build additional evidence to understand where typhoid vaccine is needed in Africa and accelerate its delivery where needed, G9000248948
OpenAlex ID: W2772425442