格鲁吉亚国布鲁氏菌病的流行病学及临床特征
Epidemiological and Clinical Features of Brucellosis in the Country of Georgia.
作者信息
Akhvlediani Tamar, Bautista Christian T, Garuchava Natalia, Sanodze Lia, Kokaia Nora, Malania Lile, Chitadze Nazibrola, Sidamonidze Ketevan, Rivard Robert G, Hepburn Matthew J, Nikolich Mikeljon P, Imnadze Paata, Trapaidze Nino
机构信息
U.S. Army Medical Research Directorate-Georgia (USAMRD-G), Tbilisi, Georgia, United States of America.
Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, United States of America.
出版信息
PLoS One. 2017 Jan 20;12(1):e0170376. doi: 10.1371/journal.pone.0170376. eCollection 2017.
BACKGROUND
Brucellosis is an endemic disease in the country of Georgia. According to the National Center for Disease Control and Public Health of Georgia (NCDC), the average annual number of brucellosis cases was 161 during 2008-2012. However, the true number of cases is thought to be higher due to underreporting. The aim of this study was to provide current epidemiological and clinical information and evaluate diagnostic methods used for brucellosis in Georgia.
METHODOLOGY
Adult patients were eligible for participation if they met the suspected or probable case definition for brucellosis. After consent participants were interviewed using a standardized questionnaire to collect information on socio-demographic characteristics, epidemiology, history of present illness, and clinical manifestation. For the diagnosis of brucellosis, culture and serological tests were used.
RESULTS
A total of 81 participants were enrolled, of which 70 (86%) were from rural areas. Seventy-four percent of participants reported consuming unpasteurized milk products and 62% consuming undercooked meat products before symptom onset. Forty-one participants were positive by the Wright test and 33 (41%) were positive by blood culture. There was perfect agreement between the Huddelston and Wright tests (k = 1.0). Compared with blood culture (the diagnostic gold standard), ELISA IgG and total ELISA (IgG + IgM), the Wright test had fair (k = 0.12), fair (k = 0.24), and moderate (k = 0.52) agreement, respectively.
CONCLUSIONS
Consumption of unpasteurized milk products and undercooked meat were among the most common risk factors in brucellosis cases. We found poor agreement between ELISA tests and culture results. This report also serves as an initial indication that the suspected case definition for brucellosis surveillance purposes needs revision. Further research is needed to characterize the epidemiology and evaluate the performance of the diagnostic methods for brucellosis in Georgia.
背景
布鲁氏菌病是格鲁吉亚的一种地方病。根据格鲁吉亚国家疾病控制与公共卫生中心（NCDC）的数据，2008年至2012年期间布鲁氏菌病病例的年均数量为161例。然而，由于报告不完整，实际病例数可能更高。本研究的目的是提供当前的流行病学和临床信息，并评估格鲁吉亚用于布鲁氏菌病的诊断方法。
方法
符合布鲁氏菌病疑似或可能病例定义的成年患者有资格参与研究。获得同意后，使用标准化问卷对参与者进行访谈，以收集社会人口学特征、流行病学、现病史和临床表现等信息。布鲁氏菌病的诊断采用培养和血清学检测。
结果
共纳入81名参与者，其中70名（86%）来自农村地区。74%的参与者报告在症状出现前食用过未经巴氏消毒的奶制品，62%的参与者食用过未煮熟的肉类产品。41名参与者wright试验呈阳性，33名（41%）血培养呈阳性。Huddelston试验和wright试验结果完全一致（k = 1.0）。与血培养（诊断金标准）相比，ELISA IgG和总ELISA（IgG + IgM），wright试验的一致性分别为一般（k = 0.12）、一般（k = 0.24）和中等（k = 0.52）。
结论
食用未经巴氏消毒的奶制品和未煮熟的肉类是布鲁氏菌病病例中最常见的危险因素。我们发现ELISA检测与培养结果之间的一致性较差。本报告还初步表明，用于布鲁氏菌病监测目的的疑似病例定义需要修订。需要进一步研究以明确格鲁吉亚布鲁氏菌病的流行病学特征并评估诊断方法的性能。
Zotero 插件