title: Brucellosis among hospitalized febrile patients in northern Tanzania.
abstract: Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable brucellosis was defined as a single reciprocal titer ≥ 160. Among 870 participants enrolled in the study, 455 (52.3%) had paired sera available. Of these, 16 (3.5%) met criteria for confirmed brucellosis. Of 830 participants with ≥ 1 serum sample, 4 (0.5%) met criteria for probable brucellosis. Brucellosis was associated with increased median age (P = 0.024), leukopenia (odds ratio [OR] 7.8, P = 0.005), thrombocytopenia (OR 3.9, P = 0.018), and evidence of other zoonoses (OR 3.2, P = 0.026). Brucellosis was never diagnosed clinically, and although all participants with brucellosis received antibacterials or antimalarials in the hospital, no participant received standard brucellosis treatment. Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania.
authors.affiliation: Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. andrew.bouley@duke.edu
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bouley
authors.forename: Holly M
authors.initials: HM
authors.lastname: Biggs
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Stoddard
authors.forename: Anne B
authors.initials: AB
authors.lastname: Morrissey
authors.forename: John A
authors.initials: JA
authors.lastname: Bartlett
authors.forename: Isaac A
authors.initials: IA
authors.lastname: Afwamba
authors.forename: Venance P
authors.initials: VP
authors.lastname: Maro
authors.forename: Grace D
authors.initials: GD
authors.lastname: Kinabo
authors.forename: Wilbrod
authors.initials: W
authors.lastname: Saganda
authors.forename: Sarah
authors.initials: S
authors.lastname: Cleaveland
authors.forename: John A
authors.initials: JA
authors.lastname: Crump
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002006:Brucellosis / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007223:Infant; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult