title: The changing pattern of human brucellosis: clinical manifestations, epidemiology, and treatment outcomes over three decades in Georgia.
abstract: BACKGROUND
  Brucellosis is an endemic infection in Georgia. We conducted a review of patient records with a suspected or confirmed diagnosis of brucellosis over three decades at the central referral hospital for brucellosis cases, the Institute of Parasitology and Tropical Medicine (IPTM) in Tbilisi. The purpose was to describe the demographic profile and clinical characteristics as well as diagnostic and treatment strategies in patients with brucellosis.
  
  
  METHODS
  Data were abstracted from randomly selected patient records at the IPTM. In total, 300 records were reviewed from three time periods: 1970-73, 1988-89, and 2004-2008.
  
  
  RESULTS
  The age distribution of patients shifted from a median age of 40 years in the first time period to 20 years in the third time period. Azeri ethnicity was an increasing proportion of the total number of cases. The frequency of relapsed infection was 14.7% (44 cases). A total of 50 patients received vaccine therapy, and although the vaccine produced immune responses, demonstrated by an increase in agglutination titers, it was not associated with improved outcome.
  
  
  CONCLUSIONS
  The demographics of brucellosis in Georgia fit a profile of persons that tend sheep. Osteoarticular complications were commonly detected, especially in children. The changing pattern of brucellosis in Georgia suggests clinicians should be updated about different trends in brucellosis in their country.
authors.affiliation: Clinical Research Unit, Technology Management Company, Tbilisi, Georgia. t_akhvlediani@yahoo.com
authors.forename: Tamar
authors.initials: T
authors.lastname: Akhvlediani
authors.forename: Danielle V
authors.initials: DV
authors.lastname: Clark
authors.forename: Giulen
authors.initials: G
authors.lastname: Chubabria
authors.forename: Otar
authors.initials: O
authors.lastname: Zenaishvili
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Hepburn
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000818:Animals; D002004:Brucella Vaccine / Q000008:administration & dosage; D002006:Brucellosis / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012756:Sheep; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002004:Brucella Vaccine