Back to Search
Start Over
High incidence of human brucellosis in a rural Pastoralist community in Kenya, 2015
- Source :
- PLoS Neglected Tropical Diseases, Vol 15, Iss 2, p e0009049 (2021), PLoS Neglected Tropical Diseases
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- Background Brucellosis occurs globally with highly variable incidence in humans from very low in North America and Western Europe to high in the Middle East and Asia. There are few data in Sub-Saharan Africa. This study estimated the incidence of human brucellosis in a pastoralist community in Kenya. Methods Between February 2015 and January 2016, we enrolled persons living in randomly selected households in Kajiado County. Free health care was offered at three facilities in the study area. Those who met the study clinical case definition completed a standardized questionnaire on demographics, clinical history and presentation. A blood sample was collected and tested by Rose Bengal test (RBT), then later tested at the Kenya Medical Research Institute laboratory for Brucella IgG and IgM by ELISA. Those who tested positive by both RBT and ELISA (IgG or IgM antibodies) were classified as confirmed while those that only tested positive for IgG or IgM antibodies were classified as probable. Further, sera were tested by polymerase chain reaction using a TaqMan Array Card (TAC) for a panel of pathogens causing AFI including Brucella spp. Annual incidence of brucellosis was calculated as the number of confirmed cases in one year/total number in the study population. Results We enrolled a cohort of 4746 persons in 804 households. Over half (52.3%) were males and the median age was 18 years (Interquartile range (IQR) 9 months– 32 years). A total of 236 patients were enrolled at three health facilities; 64% were females and the median age was 40.5 years (IQR 28–53 years). Thirty-nine (16.5%) were positive for Brucella antibodies by IgG ELISA, 5/236 (2.1%) by IgM ELISA and 4/236 (1.7%) by RBT. Ten percent (22/217) were positive by TAC. We confirmed four (1.7%) brucellosis cases giving an annual incidence of 84/100,000 persons/year (95% CI 82, 87). The incidence did not significantly vary by gender, age and location of residence. Conclusion We report a high incidence of brucellosis in humans among members of this pastoralist community. Brucellosis was the most common cause of febrile illness in this community.<br />Author summary Brucellosis is a bacterial disease that affects both humans and animals. Humans get infected via ingestion of unpasteurized animal products from infected animals and direct contact during animal abortions and deliveries. Infected animals shed bacteria for life through milk and during deliveries posing a risk to those with occupational exposure to infected animals. As such, human disease is disproportionately high in regions with high prevalence of animal brucellosis. While human brucellosis is distributed globally, incidence is low in North America and Western Europe and high in Asia and the Middle East where the disease is endemic. Data from Africa are scarce. We set out to estimate the incidence of brucellosis in a pastoralist community with documented high Brucella sero-prevalence in humans and livestock. We followed up a cohort of 804 households for one year and tested household members who became ill in three designated health facilities. We estimated an incidence of 84 cases per 100,000 persons per year in this community. We also found that Brucella was the most common pathogen among persons who had febrile illness highlighting the importance of this pathogen in this rural pastoralist community. No brucellosis intervention measures were being implemented.
- Subjects :
- Male
Rural Population
Bacterial Diseases
Epidemiology
RC955-962
Fevers
Pathology and Laboratory Medicine
Polymerase Chain Reaction
Geographical Locations
Medical Conditions
0302 clinical medicine
Interquartile range
Surveys and Questionnaires
Zoonoses
Arctic medicine. Tropical medicine
Medicine and Health Sciences
030212 general & internal medicine
Enzyme-Linked Immunoassays
Child
Animal Management
biology
Incidence (epidemiology)
Agriculture
Antibodies, Bacterial
Bacterial Pathogens
Infectious Diseases
Medical Microbiology
Child, Preschool
Cohort
Population study
Female
Pathogens
Public aspects of medicine
RA1-1270
Research Article
Neglected Tropical Diseases
Adult
medicine.medical_specialty
Livestock
Adolescent
030231 tropical medicine
Pastoralism
Enzyme-Linked Immunosorbent Assay
Brucella
Research and Analysis Methods
Microbiology
Brucellosis
Young Adult
03 medical and health sciences
Signs and Symptoms
Internal medicine
medicine
Humans
Serologic Tests
Immunoassays
Microbial Pathogens
Bacteria
business.industry
Organisms
Public Health, Environmental and Occupational Health
Infant
Biology and Life Sciences
Tropical Diseases
medicine.disease
biology.organism_classification
Kenya
Case definition
Health Care
Immunoglobulin M
Health Care Facilities
Immunoglobulin G
People and Places
Africa
Immunologic Techniques
Clinical Medicine
business
Subjects
Details
- Language :
- English
- ISSN :
- 19352735 and 19352727
- Volume :
- 15
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- PLoS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....f37188685217c475f269b37d6d5a6c51