Quantifying risk factors for human brucellosis in rural northern Tanzania.
BACKGROUND
Brucellosis is a zoonosis of veterinary, public health and economic significance in most developing countries. Human brucellosis is a severely debilitating disease that requires prolonged treatment with a combination of antibiotics. The disease can result in permanent and disabling sequel, and results in considerable medical expenses in addition to loss of income due to loss of working hours. A study was conducted in Northern Tanzania to determine the risk factors for transmission of brucellosis to humans in Tanzania.


METHODS
This was a matched case-control study. Any patient with a positive result by a competitive ELISA (c-ELISA) test for brucellosis, and presenting to selected hospitals with at least two clinical features suggestive of brucellosis such as headache, recurrent or continuous fever, sweating, joint pain, joint swelling, general body malaise or backache, was defined as a case. For every case in a district, a corresponding control was traced and matched by sex using multistage cluster sampling. Other criteria for inclusion as a control included a negative c-ELISA test result and that the matched individual would present to hospital if falls sick.


RESULTS
Multivariable analysis showed that brucellosis was associated with assisted parturition during abortion in cattle, sheep or goat. It was shown that individuals living in close proximity to other households had a higher risk of brucellosis. People who were of Christian religion were found to have a higher risk of brucellosis compared to other religions. The study concludes that assisting an aborting animal, proximity to neighborhoods, and Christianity were associated with brucellosis infection. There was no association between human brucellosis and Human Immunodeficiency Virus (HIV) serostatus. Protecting humans against contact with fluids and tissues during assisted parturition of livestock may be an important means of reducing the risk of transferring brucellosis from livestock to humans. These can be achieved through health education to the communities where brucellosis is common.
John
Kunda
K
Muhimbili Medical Research Centre, National Institute for Medical Research, Dar-es-Salaam, Tanzania. jkundas@yahoo.com
Fitzpatrick
Julie
J
French
Nigel
N
Kazwala
Rudovick
R
Kambarage
Dominic
D
Mfinanga
Godfrey S
GS
MacMillan
Alastair
A
Cleaveland
Sarah
S
D000818:Animals; D001826:Body Fluids / Q000382:microbiology; D002006:Brucellosis / Q000453:epidemiology / Q000635:transmission*; D016022:Case-Control Studies; D002417:Cattle; D006041:Goats; D006801:Humans; D016555:Matched-Pair Analysis; D036801:Parturition; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D012756:Sheep; D013636:Tanzania