Human Brucellosis: Methods of Diagnosis and Risk Factors among Egyptian Patients admitted at Assiut Fever Hospital .

Abstract

Background: Human brucellosis, a common zoonotic disease, is major public health problem in many countries worldwide including Egypt. Objectives: To define brucellosis patients' risk-factors and to assess diagnostic lab methods of brucellosis at Assiut Fever Hospital. Patients and Methods: The study recruited 98 patients with brucellosis and an equal number of controls. All participants were subjected to interview, clinical examination, and lab investigations. Results: Older age, males, rural residence, low socioeconomic status were significant risk-factors (OR=3.76, 2.04, 2.86, 2.72; respectively). Occupations had animals' contact were significant risk-factor (OR=4.7); the most risky were butchers/ slaughter workers (OR=8.0) and farmers/dairy workers (OR=3.59). Longer occupational exposure was risk-factor (OR=15.57). The main significant presenting symptoms were fever and musucloskeletal affections. The main significant signs were high temperature and hepato-and spleno-megaly. Standard agglutination test (SAT) titer 1/320 was the cutoff point for diagnosis and significantly lies in area under the ROC curve, sensitivity=96.4% and specificity=100.0%. Blood culture was positive in 58.2% of cases with no significant differences between SAT titer and blood culture positivity. ELISA IgM and IgG results were positive in 69.4% and 65.3% of the cases with no significant differences between SAT titer and IgM and IgG results. Conclusions: Human brucellosis has many preventable risk-factors; its diagnosis depends mainly on presence of risk-factors, clinically suspected, and SAT titer ≥1/320.