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BioMed Research International 2018. Brucellosis has a wide spectrum of clinical manifestations and it may last several days or even several years; however, it is often misdiagnosed and therefore may... (Meta-Analysis)
Meta-Analysis Review
. Brucellosis has a wide spectrum of clinical manifestations and it may last several days or even several years; however, it is often misdiagnosed and therefore may cause inadequate therapy and prolonged illness. Previous studies about meta-analysis of manifestations of brucellosis reported in English lacked the data published in Chinese, which did not provide details about the contact history, laboratory tests, and misdiagnosis. We undertake a meta-analysis of clinical manifestations of human brucellosis in China to identify those gaps in the literature. We have searched published articles in electronic databases up to December 2016 identified as relating to clinical features of human brucellosis in China. 68 studies were included in the analysis. The main clinical manifestations were fever, fatigue, arthralgia, and muscle pain (87%, 63%, 62%, and 56%, resp.). There are significant differences between adults and children. Rash, respiratory and cardiac complications, and orchitis/epididymitis were more prevalent in children patients. The common complications of brucellosis were hepatitis, followed by osteoarthritis, respiratory diseases, cardiovascular diseases, central nervous system dysfunction, hemophagocytic syndrome, and orchitis/epididymitis in male. In the nonpastoral areas, brucellosis has a high ratio of misdiagnosis. Our analysis provides further evidence for the accurate diagnosis, particularly in assessing severe, debilitating sequelae of this infection.
Topics: Adult; Brucellosis; Child, Preschool; China; Diagnostic Errors; Geography; Humans; Incidence
PubMed: 29850535
DOI: 10.1155/2018/5712920 -
Veterinary Medicine (Auckland, N.Z.) 2021Brucellosis is an infectious and widespread zoonotic disease caused by bacteria of the genus and can induce considerable human suffering and huge economic losses in... (Review)
Review
Brucellosis is an infectious and widespread zoonotic disease caused by bacteria of the genus and can induce considerable human suffering and huge economic losses in animals. Thus, the aim of this study was to conduct a systematic review and meta-analysis on the seroprevalence of bovine brucellosis in Ethiopia. PubMed, Science Direct, African Journals Online, and Google Scholar were used to search the articles. All references were screened and articles, which reported seroprevalence of bovine brucellosis in Ethiopia were included in the study. Meta-analysis using random-effects models was made to calculate the pooled seroprevalence of brucellosis. This review included 15 papers. The estimated pooled seroprevalence of brucellosis was found to be 3.0% (95% CI: 2.0, 4.0). The subgroup analysis showed that there was a statistically significant association between the disease and geographical location, setting, laboratory technique employed and study years. Also, there was some evidence of publication bias (Egger's test, = 0.0003) on studies reporting the prevalence of brucellosis in Ethiopia. This review proves a high seroprevalence of brucellosis in the country and appropriate control strategies are recommended. Moreover, further study on the risk factors is also required to develop cost-effective preventive strategies.
PubMed: 33469511
DOI: 10.2147/VMRR.S289721 -
Scientific Reports Mar 2021This study aimed to consolidate current knowledge of wildlife brucellosis in Africa and to analyse available predictors of infection. The Preferred Reporting Items for... (Meta-Analysis)
Meta-Analysis
This study aimed to consolidate current knowledge of wildlife brucellosis in Africa and to analyse available predictors of infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Information on species, test used, test results, area, rainfall, livestock and wildlife contact and year of study were extracted. This systematic review revealed 42 prevalence studies, nine disease control articles and six articles on epidemiology. Brucella abortus, Brucella melitensis, Brucella inopinata and Brucella suis were reported in wildlife. The prevalence studies revealed serological evidence of brucellosis in buffalo, antelope (positive in 14/28 species), carnivores (4/12) and other species (7/20) over the last five decades. Buffalo populations were more likely to be infected and had a higher seroprevalence than other species; the pooled seroprevalence was 13.7% (95% CI 10.3-17.3%) in buffalo, 7.1% (95% CI 1.1-15.5%) in carnivores and 2.1% (95% CI 0.1-4.9%) in antelope. Wildlife in high rainfall areas (≥ 800 mm) were more likely to be infected, and infected populations showed higher seroprevalence in high rainfall areas and in studies published after 2000. Domestic animal contact was associated with increased seroprevalence in antelope and carnivore species, but not in buffalo, supporting the hypothesis that buffalo may be a reservoir species.
Topics: Africa; Animal Diseases; Animals; Animals, Wild; Arachnid Vectors; Brucella; Brucellosis; Cross-Sectional Studies; Host-Pathogen Interactions; Multivariate Analysis; Public Health Surveillance; Seroepidemiologic Studies; Ticks; Zoonoses
PubMed: 33727580
DOI: 10.1038/s41598-021-85441-w -
Frontiers in Veterinary Science 2022Brucellosis is one of the most prevalent zoonotic diseases common between humans and animals. Despite eradication efforts, the burden of the disease is well-known in...
OBJECTIVES
Brucellosis is one of the most prevalent zoonotic diseases common between humans and animals. Despite eradication efforts, the burden of the disease is well-known in endemic countries and in countries where brucellosis has not been an important health issue until recently. The aim of this study was to evaluate the prevalence, diagnosis, and manifestations of brucellosis.
METHODS
In this study, PubMed, Web of Science, Scopus, Embase, and Google scholar databases were systematically searched to find studies published from 2011 to 2021. The search was conducted using text words and Medical Subject Headings (MeSH) Terms on the prevalence of brucellosis. Stata software 14.0 was used for all analyses.
RESULTS
Based on the results, the pooled prevalence of brucellosis was 15.27% (95% CI: 9.68-21.86; heterogeneity index: 97.43; < 0.001) for man and 15.33% (95% CI: 7.19-25.75; heterogeneity index: 98.19; < 0.001) for woman. Age (coefficient: 0.240; = 0.480), gender (coefficient: -0.017; = 0.800), and publication year (coefficient: 0.114; = 0.861) showed no significant effect on heterogeneity among studies. Egger's test indicated a significant publication bias for the prevalence of brucellosis (coefficient 3.894; < 0.001). Moreover, the trim-and-fill method exhibited that the adjusted prevalence of brucellosis (18.30%, 95% CI: 14.10-22.52) was not significantly different from the original prevalence of brucellosis.
CONCLUSION
The pooled estimate for brucellosis prevalence was estimated as 15.53%. To better understand the epidemiology of brucellosis globally, more extensive studies are needed to be conducted throughout the world, especially in developing and low-income countries.
PubMed: 36619963
DOI: 10.3389/fvets.2022.976215 -
Emerging Microbes & Infections Dec 2023Balancing the potentially serious outcomes of asymptomatic brucellosis and "waiting" for treatment in clinical practice is an urgent issue. Therefore, we assessed the... (Meta-Analysis)
Meta-Analysis
Balancing the potentially serious outcomes of asymptomatic brucellosis and "waiting" for treatment in clinical practice is an urgent issue. Therefore, we assessed the follow-up outcomes and epidemiological characteristics of asymptomatic brucellosis in the absence of treatment to provide evidence-based clinical clues. We searched eight databases in which 3610 studies from 1990 to 2021 were related to the follow-up outcomes of asymptomatic brucellosis. Thirteen studies, involving 107 cases, were finally included. Regarding the follow-up outcomes, we examined the presence or absence of symptoms and decreased serum agglutination test (SAT) titre. During the 0.5-18 months follow-up period, the pooled prevalence of appearing symptomatic was 15.4% (95% CI 2.1%-34.3%), cases that remained asymptomatic were 40.3% (95% CI 16.6%-65.8%), and decreased SAT titre was observed in 36.5% (95% CI 11.6%-66.1%). Subgroup analysis indicated that the pooled prevalence of appearing symptomatic with follow-up times of less than 6 months, 6-12 months, and 12-18 months was 11.5%, 26.4%, and 47.6%, respectively. The student subgroup had a higher prevalence of symptoms (46.6%) than the occupational and family populations. In conclusion, asymptomatic brucellosis has a high likelihood of appearing symptomatic and its severity may be underestimated. Active screening of occupational and family populations should be enhanced, and special attention should be paid to high-titre students for early intervention, if necessary. Additionally, future prospective, long-term, and large-sample follow-up studies are essential.
Topics: Humans; Follow-Up Studies; Brucellosis; Agglutination Tests; Prevalence
PubMed: 36849445
DOI: 10.1080/22221751.2023.2185464 -
New Microbes and New Infections Sep 2023Bovine brucellosis is a significant public health problem in countries with economic and zoonotic implications. Although relevant, there are no previous systematic... (Review)
Review
INTRODUCTION
Bovine brucellosis is a significant public health problem in countries with economic and zoonotic implications. Although relevant, there are no previous systematic reviews about bovine brucellosis in Latin America.
METHODS
We performed a systematic literature review in five data-bases to assess the seroprevalence of Brucella in cattle. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95% confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I test) were reported.
RESULTS
The literature search yielded 3,403 articles, of which 65 studies were fully valid for analysis. The pooled seroprevalence for Brucella in bovine (n = 46,883,177) was 4.0% (95%CI: 3.0%-5.0%; p < 0.001), and Venezuela was the country with the highest prevalence (16.0%). By regions, the highest seroprevalence is in Central America and the Caribbean islands (8.0%,95%CI: 3.0%-15.0%; p < 0.001, I = 99.85).
CONCLUSIONS
Some countries reported still relevant seroprevalences of bovine brucellosis, especially at the Central America and Caribbean islands. Multiple factors may influence the survival and spread of pathogens in the environment; farms located in regions bordering forest areas, in areas of difficult access to the veterinary service; extensive beef herds raised at pastures with different age and productive groups inter-mingled, and minimal concerns regarding hygiene practices and disease prevention measures. Bovine brucellosis has not been eliminated and needs to be considered with new tools for prevention and control, especially being a zoonosis.
PubMed: 37692289
DOI: 10.1016/j.nmni.2023.101168 -
PLoS Neglected Tropical Diseases Jan 2019Infection of bones and joints remains one of the most commonly described complications of brucellosis in humans and is predominantly reported in all ages and sexes in... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Infection of bones and joints remains one of the most commonly described complications of brucellosis in humans and is predominantly reported in all ages and sexes in high-risk regions, such as the Middle East, Asia, South and Central America, and Africa. We aimed to systematically review the literature and perform a meta-analysis to estimate the global prevalence of osteoarticular brucellosis (OAB).
METHODOLOGY
Major bibliographic databases were searched using keywords and suitable combinations. All studies reporting the incidence and clinical manifestations of osteoarticular brucellosis in humans, and demonstrated by two or more diagnostic methods (bacteriological, molecular, serological, and/or radiographic) were included. Random model was used, and statistical significance was set at 0.05.
PRINCIPAL FINDINGS
A total of 56 studies met the inclusion criteria and were included in the systematic review and meta-analysis. There was an evidence of geographical variation in the prevalence of osteoarticular disease with estimates ranging from 27% in low-risk regions to 36% in high-risk regions. However, the difference was not significant. Thus, brucellosis patients have at least a 27% chance of developing osteoarticular disease.
CONCLUSIONS
The prevalence of OAB is not dependent on the endemicity of brucellosis in a particular region. Hence, further research should investigate the potential mechanisms of OAB, as well as the influence of age, gender, and other socioeconomic factor variations in its global prevalence, as this may provide insight into associated exposure risks and management of the disease.
Topics: Brucellosis; Global Health; Humans; Incidence; Osteoarthritis; Prevalence; Risk Assessment; Topography, Medical
PubMed: 30657765
DOI: 10.1371/journal.pntd.0007112 -
PLoS Neglected Tropical Diseases 2012The objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of specifying a disability weight for a DALY calculation.
METHODS/PRINCIPAL FINDINGS
Thirty three databases were searched, with 2,385 articles published between January 1990-June 2010 identified as relating to human brucellosis. Fifty-seven studies were of sufficient quality for data extraction. Pooled proportions of cases with specific clinical manifestations were stratified by age category and sex and analysed using generalized linear mixed models. Data relating to duration of illness and risk factors were also extracted. Severe complications of brucellosis infection were not rare, with 1 case of endocarditis and 4 neurological cases per 100 patients. One in 10 men suffered from epididymo-orchitis. Debilitating conditions such as arthralgia, myalgia and back pain affected around half of the patients (65%, 47% and 45%, respectively). Given that 78% patients had fever, brucellosis poses a diagnostic challenge in malaria-endemic areas. Significant delays in appropriate diagnosis and treatment were the result of health service inadequacies and socioeconomic factors. Based on disability weights from the 2004 Global Burden of Disease Study, a disability weight of 0.150 is proposed as the first informed estimate for chronic, localised brucellosis and 0.190 for acute brucellosis.
CONCLUSIONS
This systematic review adds to the understanding of the global burden of brucellosis, one of the most common zoonoses worldwide. The severe, debilitating, and chronic impact of brucellosis is highlighted. Well designed epidemiological studies from regions lacking in data would allow a more complete understanding of the clinical manifestations of disease and exposure risks, and provide further evidence for policy-makers. As this is the first informed estimate of a disability weight for brucellosis, there is a need for further debate amongst brucellosis experts and a consensus to be reached.
Topics: Brucellosis; Endocarditis, Bacterial; Epididymitis; Female; Humans; Male; Nervous System Diseases; Orchitis
PubMed: 23236528
DOI: 10.1371/journal.pntd.0001929 -
BMC Public Health Aug 2016Brucellosis is a debilitating zoonotic disease affecting humans and animals. A comprehensive, evidence-based assessment of literature and officially available data on... (Review)
Review
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
Topics: Animal Husbandry; Animals; Animals, Domestic; Animals, Wild; Brucella; Brucella abortus; Brucella melitensis; Brucellosis; Cattle; Communicable Diseases, Emerging; Humans; Incidence; Kenya; Risk Factors; Zoonoses
PubMed: 27549329
DOI: 10.1186/s12889-016-3532-9 -
International Journal of Infectious... Aug 2018The aim was to establish the incidence of adverse outcomes with brucellosis infection during pregnancy. (Review)
Review
BACKGROUND
The aim was to establish the incidence of adverse outcomes with brucellosis infection during pregnancy.
METHODS
Ovid Medline (1946-), Ovid Embase (1974-), and Web of Science (Clarivate Analytics) (1900-), the World Health Organization website and Google were searched September 27, 2017 for (i) outcomes with brucellosis diagnosed during pregnancy and (ii) studies with retrospective diagnosis of maternal brucellosis following adverse pregnancy outcomes.
RESULTS
Sixty studies met inclusion criteria. In 65 pregnancies from 28 case reports and 9 small case series (<10 women), there were 20 spontaneous abortions (SAs) (31%), 2 intra-uterine fetal deaths (IUFDs) (3%) and 11 cases of congenital brucellosis (17%). In 14 larger case series there were 181 SAs in 679 pregnancies (27%), 19 IUFDs in 458 pregnancies (4%), and 44 preterm infants (12%) plus 6 infants with congenital brucellosis (2%) in 362 pregnancies. SA, IUFD and preterm delivery incidence were increased with meta-analysis of the 5 case series with controls. Nine studies described brucellosis seroprevalence with adverse pregnancy outcomes with no increased seroprevalence in the two studies with controls.
CONCLUSIONS
Brucellosis almost certainly causes SA with increasing evidence that it also leads to IUFD and prematurity. Congenital brucellosis occurs in approximately 2% of infants exposed in-utero.
Topics: Abortion, Spontaneous; Brucellosis; Female; Fetal Death; Humans; Obstetric Labor, Premature; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies
PubMed: 29885371
DOI: 10.1016/j.ijid.2018.05.023