Risk Factors for Human Brucellosis in Northern Tanzania.
Risk Factors for Human Brucellosis in Northern Tanzania.
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DOI：
10.4269/ajtmh.17-0125
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发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Crump JA
中科院分区：
文献类型：
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作者：
Cash-Goldwasser S;Maze MJ;Rubach MP;Biggs HM;Stoddard RA;Sharples KJ;Halliday JEB;Cleaveland S;Shand MC;Mmbaga BT;Muiruri C;Saganda W;Lwezaula BF;Kazwala RR;Maro VP;Crump JA
对撒哈拉以南非洲地区人类布鲁氏菌病的流行病学知之甚少。这阻碍了个人和群体层面的预防和控制工作。为了评估坦桑尼亚北方布鲁氏菌病的危险因素，我们对坦桑尼亚莫希两家医院的发热患者进行了一项研究。在入组时和4-6周随访时采集血清，通过布鲁氏菌微量凝集试验进行检测。在患有临床相容性疾病的受试者中，确诊的布鲁氏菌病病例定义为配对血清之间的凝集滴度升高≥ 4倍或布鲁氏菌属的血培养阳性，可能的布鲁氏菌病病例定义为单个倒数滴度≥ 160。对照在配对血清中具有< 20的倒数滴度。我们收集了人口统计学和临床信息，并进行了风险因素问卷调查。在分析的562名参与者中，50名（8.9%）确诊或可能患有布鲁氏菌病。多因素分析显示，布鲁氏菌病的危险因素包括协助山羊或绵羊分娩（比值比[OR] 5.9，95%置信区间[CI] 1.4，24.6）和与牛接触（OR 1.2，95% CI 1.0，1.4）。食用煮沸或巴氏杀菌的乳制品对布鲁氏菌病具有保护作用（OR 0.12，95% CI 0.02，0.93）。没有参与者从其医疗保健提供者那里获得了布氏杆菌病的临床诊断。医护人员对布鲁氏菌病的认识不足可以通过临床医生教育和更好地获得布鲁氏菌病诊断检测来解决。需要采取干预措施，重点保护牲畜饲养者，特别是那些帮助山羊或绵羊分娩的人。
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.
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影响因子：
1.8
作者：
Asiimwe BB;Kansiime C;Rwego IB
通讯作者：
Rwego IB
影响因子：
3.7
作者：
John K;Fitzpatrick J;French N;Kazwala R;Kambarage D;Mfinanga GS;MacMillan A;Cleaveland S
通讯作者：
Cleaveland S
影响因子：
56.3
作者：
Reddy, Elizabeth A.;Shaw, Andrea V.;Crump, John A.
通讯作者：
Crump, John A.
影响因子：
3.9
作者：
Rubach MP;Halliday JE;Cleaveland S;Crump JA
通讯作者：
Crump JA
DOI：
10.1196/annals.1428.015
发表时间：
2008-01-01
期刊：
ANIMAL BIODIVERSITY AND EMERGING DISEASES: PREDICTION AND PREVENTION
影响因子：
--
作者：
Makita, Kohei;Fevre, Eric Maurice;Welburn, Susan Christina
通讯作者：
Welburn, Susan Christina