Systematic review of brucellosis in Kenya: disease frequency in humans and animals and risk factors for human infection.
Systematic review of brucellosis in Kenya: disease frequency in humans and animals and risk factors for human infection.
复制标题
肯尼亚布鲁氏菌病的系统审查：人畜发病频率和人感染的危险因素。
DOI：
10.1186/s12889-016-3532-9
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发表时间：
2016-08-22
影响因子：
4.5
通讯作者：
Neubauer H
中科院分区：
文献类型：
--
作者：
Njeru J;Wareth G;Melzer F;Henning K;Pletz MW;Heller R;Neubauer H
布鲁氏菌病是一种影响人类和动物的人畜共患疾病。缺少对肯尼亚动物和人类布鲁氏菌病文献和官方可用数据的全面、循证评估。本次审查的目的是提供人类、动物布鲁氏菌病的频率估计以及人类感染的危险因素，并帮助了解肯尼亚的现状。对 1916 年至 2016 年期间总共 36 份关于布鲁氏菌病的国家和国际出版物进行了审查，以估计人类和动物中布鲁氏菌病的频率，以及肯尼亚人类潜在风险因素与血清阳性之间的关联强度。所进行的研究仅揭示了流行病学背景下疾病时空分布的少量且零散的证据。细菌学证据显示牛和人类患者体内存在流产布鲁氏菌和羊布鲁氏菌，而猪布鲁氏菌仅从野生啮齿动物中分离出来。目前尚无小型反刍动物和其他动物物种中布鲁氏菌感染的类似证据。早期和最近的血清学研究表明，动物布鲁氏菌病广泛存在于所有动物生产系统中。由于来自不同地理区域的大量动物混合、牲畜寻找牧场、公共共享牧场以及动物集中在水点周围，这些系统中的动物感染压力仍然很大。人类病例更可能出现在因职业或家庭接触牲畜或从事危险社会文化活动（例如食用生血和乳制品以及在家园内屠宰动物）的群体中。由于缺乏可靠的实验室诊断支持，导致患者健康状况不佳和常规疾病漏报，许多布鲁氏菌病患者被误诊并可能受到虐待。我们没有发现有关疾病发病率估计或疾病控制工作的研究。由于畜牧业活动和促进布鲁氏菌病传播的社会文化活动并存，布鲁氏菌病重新出现和传播的风险是显而易见的。需要在全国范围内对人类/牲畜/野生动物界面的布鲁氏菌病进行精心设计、基于证据的多学科研究。这些可以帮助生成可靠的频率和潜在影响估计，识别布鲁氏菌储存库，并提出已证明有效的控制策略。
Brucellosis is a debilitating zoonotic disease affecting humans and animals. A comprehensive, evidence-based assessment of literature and officially available data on animal and human brucellosis for Kenya are missing. The aim of the current review is to provide frequency estimates of brucellosis in humans, animals and risk factors for human infection, and help to understand the current situation in Kenya. A total of accessible 36 national and international publications on brucellosis from 1916 to 2016 were reviewed to estimate the frequency of brucellosis in humans and animals, and strength of associations between potential risk factors and seropositivity in humans in Kenya. The conducted studies revealed only few and fragmented evidence of the disease spatial and temporal distribution in an epidemiological context. Bacteriological evidence revealed the presence of Brucella (B.) abortus and B. melitensis in cattle and human patients, whilst B. suis was isolated from wild rodents only. Similar evidence for Brucella spp infection in small ruminants and other animal species is unavailable. The early and most recent serological studies revealed that animal brucellosis is widespread in all animal production systems. The animal infection pressure in these systems has remained strong due to mixing of large numbers of animals from different geographical regions, movement of livestock in search of pasture, communal sharing of grazing land, and the concentration of animals around water points. Human cases are more likely seen in groups occupationally or domestically exposed to livestock or practicing risky social-cultural activities such as consumption of raw blood and dairy products, and slaughtering of animals within the homesteads. Many brucellosis patients are misdiagnosed and probably mistreated due to lack of reliable laboratory diagnostic support resulting to adverse health outcomes of the patients and routine disease underreporting. We found no studies of disease incidence estimates or disease control efforts. The risk for re-emergence and transmission of brucellosis is evident as a result of the co-existence of animal husbandry activities and social-cultural activities that promote brucellosis transmission. Well-designed countrywide, evidence-based, and multidisciplinary studies of brucellosis at the human/livestock/wildlife interface are needed. These could help to generate reliable frequency and potential impact estimates, to identify Brucella reservoirs, and to propose control strategies of proven efficacy.