Risk factors for human brucellosis in northern Tanzania

Cash-Goldwasser, S. et al. (2018) Risk factors for human brucellosis in northern Tanzania. American Journal of Tropical Medicine and Hygiene, 98(2), pp. 598-606. (doi:10.4269/ajtmh.17-0125) (PMID:29231152) (PMCID:PMC5929176)

Cash-Goldwasser, S. et al. (2018) Risk factors for human brucellosis in northern Tanzania. American Journal of Tropical Medicine and Hygiene, 98(2), pp. 598-606. (doi:10.4269/ajtmh.17-0125) (PMID:29231152) (PMCID:PMC5929176)

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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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Halliday, Dr Joanna and Cleaveland, Professor Sarah and Shand, Mr Michael
Authors: Cash-Goldwasser, S., Maze, M. J., Rubach, M. P., Biggs, H. M., Stoddard, R. A., Sharples, K. J., Halliday, J. E.B., Cleaveland, S., Shand, M. C., Mmbaga, B. T., Muiruri, C., Saganda, W., Lwezaula, B. F., Kazwala, R. R., Maro, V. P., and Crump, J. A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:American Journal of Tropical Medicine and Hygiene
Publisher:American Society of Tropical Medicine and Hygiene
ISSN:0002-9637
ISSN (Online):1476-1645
Published Online:11 December 2017
Copyright Holders:Copyright © 2017 The American Society of Tropical Medicine and Hygiene
First Published:First published in American Journal of Tropical Medicine and Hygiene 98(2):598-606
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
568221Impact, ecology and social determinants of bacterial zoonoses in northern TanzaniaSarah CleavelandBiotechnology and Biological Sciences Research Council (BBSRC)BB/J010367/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
627871Social, economic and environmental drivers of zoonoses in Tanzania (SEEDZ)Sarah CleavelandBiotechnology and Biological Sciences Research Council (BBSRC)BB/L018926/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
628341Hazards associated with zoonotic enteric pathogens in emerging livestock meat pathways (HAZEL)Ruth ZadoksBiotechnology and Biological Sciences Research Council (BBSRC)BB/L017679/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED
628321Molecular epidemology of brucellosis in northern TanzaniaDaniel HaydonBiotechnology and Biological Sciences Research Council (BBSRC)BB/L018845/1RI BIODIVERSITY ANIMAL HEALTH & COMPMED