控制布氏杆菌病措施对人类疾病特征的影响：巴尔干半岛流行地区的经验。

Impact of measures to control brucellosis on disease characteristics in humans: experience from an endemic region in the Balkans.

机构信息

a University clinic for infectious diseases and febrile conditions, Medical Faculty , Ss. Cyril and Methodius University , Skopje , Republic of Macedonia.

b Public Health Center Skopje , Republic of Macedonia.

出版信息

Infect Dis (Lond). 2018 May;50(5):340-345. doi: 10.1080/23744235.2017.1407037. Epub 2017 Dec 1.

DOI:10.1080/23744235.2017.1407037

PMID:29192529

Abstract

AIM

To analyze the impact of measures undertaken to control brucellosis in the Republic of Macedonia on demographic, epidemiological and clinical characteristics of the disease in humans.

METHODS

Demographic, epidemiological and clinical characteristics of 340 patients with brucellosis were retrospectively analyzed. Patients were treated at the University Clinic of Infectious Diseases in Skopje during three time periods: 1989-1990 when no national strategy for disease control existed, 2000-2001 when some activities for control were performed and 2011-2014 when an organized and financially supported strategy was accomplished.

RESULTS

A drastic decrease of the number of cases of human brucellosis during the last period when compared to the first two ones (3.9 and 3.3 times lower, respectively) was evident. Patients from the third period were significantly older, with median age 41 years (range 4-73) vs. 31 years (3-77) and 34 years (1-74), respectively (p = .013). There were more males (86.6 vs. 73.6% and 63.2%, respectively, p = .002) and the disease was more often acquired professionally (80.6 vs. 60.1% and 59.2%, respectively, p = .006). Fewer patients from the third period had elevated body temperature either as a symptom (50.7 vs. 73.6% and 69.6%, respectively, p = .003), or as a sign (35.8 vs. 55.4% and 56.8%, respectively, p = .011) and less often exhibited focal forms (40.3 vs. 56.8% and 64.0%, respectively, p = .007).

CONCLUSION

The national strategy for brucellosis control, which included vaccination of small ruminants, resulted in a decrease of human brucellosis cases in the Republic of Macedonia and there was a tendency to milder disease manifestations.

摘要

目的

分析在马其顿共和国实施的布鲁氏菌病控制措施对人类疾病的人口统计学、流行病学和临床特征的影响。

方法

回顾性分析了在斯科普里传染病大学诊所治疗的 340 名布鲁氏菌病患者的人口统计学、流行病学和临床特征。患者在三个时期接受治疗：1989-1990 年，当时没有国家疾病控制战略；2000-2001 年，进行了一些控制活动；2011-2014 年，实施了有组织和有资金支持的战略。

结果

与前两个时期相比（分别低 3.9 和 3.3 倍），最后一个时期人类布鲁氏菌病的病例数量明显减少。第三时期的患者年龄明显较大，中位年龄为 41 岁（范围为 4-73），而第一和第二时期的年龄分别为 31 岁（范围为 3-77）和 34 岁（范围为 1-74）（p=0.013）。男性患者更多（分别为 86.6%、73.6%和 63.2%，p=0.002），疾病更多地是职业性获得（分别为 80.6%、60.1%和 59.2%，p=0.006）。第三时期的患者中，体温升高作为症状（分别为 50.7%、73.6%和 69.6%，p=0.003）或体征（分别为 35.8%、55.4%和 56.8%，p=0.011）的比例较低，且较少表现为局灶性形式（分别为 40.3%、56.8%和 64.0%，p=0.007）。