Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece
Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece
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DOI：
10.1023/a:1023368420840
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发表时间：
2003-01-01
影响因子：
13.6
通讯作者：
Kondakis, X
中科院分区：
文献类型：
--
作者：
Bikas, C;Jelastopulu, E;Kondakis, X
在希腊西部的亚该亚农村地区进行了一项病例对照研究，以检查布鲁氏菌病的危险因素。研究的参与者为414人（占被调查城市总人口的7.5%）。病例（n = 140）由临床症状定义，并由阳性标准凝集试验（SAT）确认。所有病例都是在1997年1月至1999年3月期间由当地保健中心的医生或私人开业医生诊断的。两个标准是确定疾病的基本标准。第一项是临床症状，如发热、疲劳、关节痛和全身疼痛，第二项是SAT滴度至少1：160。对照组（n = 274）与病例的年龄和性别以1：2的比例匹配。对因其他疾病前往当地卫生中心就诊的患者进行了大约的对照收集。由同一位医生通过个人访谈收集数据，并通过logistic回归模型进行分析。该地区的总发病率为1110/100 000。以“无动物所有权”和“无动物接触”作为参考类别，最强的风险因素是动物交付期间的创伤，比值比（OR）：24.3; 95%置信区间（CI）：8.8-67.5，其次是没有马厩（OR：14.4; 95% CI：4.7-44.1）。应用多元逐步分析后，模型中保留的调整后的危险因素是居住地（OR：1.8; 95% CI：1.1-3.1），动物专业职业（OR：2.4; 95% CI：1.2-4.8）、无马厩（OR：9.1; 95% CI：2.2-38.7）和动物分娩期间的创伤（OR：11.2; 95% CI：3.2-39.1）。食用巴氏杀菌奶或食用成熟3个月以上的奶酪被认为是一个保护因素（OR：0.27; 95%CI：0.11-0.67）。检测动物布鲁氏菌病对预防该病至关重要。此外，应制定有效的预防措施，以消除这种疾病。
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.