Musallam I I, Abo-Shehada M N, Hegazy Y M, Holt H R, Guitian F J
Veterinary Epidemiology,Economics and Public Health Group,Department of Production and Population Health,The Royal Veterinary College,University of London,Hatfield,UK.
Faculty of Epidemiology and Population Health,London School of Hygiene and Tropical Medicine,Keppel Street,London,UK.
Epidemiol Infect. 2016 Mar;144(4):671-85. doi: 10.1017/S0950268815002575. Epub 2015 Oct 28.
A systematic review of studies providing frequency estimates of brucellosis in humans and ruminants and risk factors for Brucella spp. seropositivity in humans in the Middle East was conducted to collate current knowledge of brucellosis in this region. Eight databases were searched for peer-reviewed original Arabic, English, French and Persian journal articles; the search was conducted on June 2014. Two reviewers evaluated articles for inclusion based on pre-defined criteria. Of 451 research articles, only 87 articles passed the screening process and provided bacteriological and serological evidence for brucellosis in all Middle Eastern countries. Brucella melitensis and B. abortus have been identified in most countries in the Middle East, supporting the notion of widespread presence of Brucella spp. especially B. melitensis across the region. Of the 87 articles, 49 were used to provide evidence of the presence of Brucella spp. but only 11 provided new knowledge on the frequency of brucellosis in humans and ruminants or on human risk factors for seropositivity and were deemed of sufficient quality. Small ruminant populations in the region show seroprevalence values that are among the highest worldwide. Human cases are likely to arise from subpopulations occupationally exposed to ruminants or from the consumption of unpasteurized dairy products. The Middle East is in need of well-designed observational studies that could generate reliable frequency estimates needed to assess the burden of disease and to inform disease control policies.
开展了一项系统性综述，对提供人类和反刍动物布鲁氏菌病频率估计值以及中东地区人类布鲁氏菌属血清阳性危险因素的研究进行分析，以梳理该地区布鲁氏菌病的现有知识。检索了八个数据库，查找经同行评审的阿拉伯语、英语、法语和波斯语原创期刊文章；检索于2014年6月进行。两名评审员根据预先确定的标准评估文章是否纳入。在451篇研究文章中，只有87篇通过了筛选过程，并提供了中东所有国家布鲁氏菌病的细菌学和血清学证据。在中东的大多数国家都已鉴定出羊种布鲁氏菌和牛种布鲁氏菌，这支持了布鲁氏菌属广泛存在的观点，尤其是羊种布鲁氏菌在该地区广泛存在。在这87篇文章中，49篇用于提供布鲁氏菌属存在的证据，但只有11篇提供了关于人类和反刍动物布鲁氏菌病频率或人类血清阳性危险因素的新知识，且被认为质量足够高。该地区小反刍动物群体的血清阳性率在全球范围内处于最高水平。人类病例可能源于职业接触反刍动物的亚群体或食用未巴氏杀菌的乳制品。中东地区需要精心设计的观察性研究，以得出评估疾病负担和为疾病控制政策提供依据所需的可靠频率估计值。
