Carugati Manuela, Biggs Holly M, Maze Michael J, Stoddard Robyn A, Cash-Goldwasser Shama, Hertz Julian T, Halliday Jo E B, Saganda Wilbrod, Lwezaula Bingileki F, Kazwala Rudovick R, Cleaveland Sarah, Maro Venance P, Rubach Matthew P, Crump John A
Division of Infectious Diseases, Duke University Medical Center, Durham, NC, USA.
Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Trans R Soc Trop Med Hyg. 2018 Mar 1;112(3):136-143. doi: 10.1093/trstmh/try033.
Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utilization data, we estimated the incidence of brucellosis in Moshi Urban and Moshi Rural Districts, Kilimanjaro Region, Tanzania, for the periods 2007-2008 and 2012-2014.
Cases were identified among febrile patients at two sentinel hospitals and were defined as having either a 4-fold increase in Brucella microscopic agglutination test titres between acute and convalescent serum or a blood culture positive for Brucella spp. Findings from a health care utilization survey were used to estimate multipliers to account for cases not seen at sentinel hospitals.
Of 585 patients enrolled in the period 2007-2008, 13 (2.2%) had brucellosis. Among 1095 patients enrolled in the period 2012-2014, 32 (2.9%) had brucellosis. We estimated an incidence (range based on sensitivity analysis) of brucellosis of 35 (range 32-93) cases per 100 000 persons annually in the period 2007-2008 and 33 (range 30-89) cases per 100 000 persons annually in the period 2012-2014.
We found a moderate incidence of brucellosis in northern Tanzania, suggesting that the disease is endemic and an important human health problem in this area.
布鲁氏菌病在人类及其家畜中导致大量发病。对撒哈拉以南非洲地区布鲁氏菌病发病率的可靠估计很少。利用通过哨点医院监测和医疗保健利用数据确定的病例，我们估算了坦桑尼亚乞力马扎罗地区莫希市区和莫希农村地区2007 - 2008年以及2012 - 2014年期间布鲁氏菌病的发病率。
在两家哨点医院的发热患者中确定病例，定义为急性和恢复期血清布鲁氏菌显微镜凝集试验滴度增加4倍，或血培养布鲁氏菌属阳性。利用医疗保健利用调查结果估算乘数，以计入未在哨点医院就诊的病例。
在2007 - 2008年期间登记的585名患者中，13名（2.2%）患有布鲁氏菌病。在2012 - 2014年期间登记的1095名患者中，32名（2.9%）患有布鲁氏菌病。我们估算2007 - 2008年期间布鲁氏菌病的发病率（基于敏感性分析的范围）为每10万人每年35例（范围32 - 93例），2012 - 2014年期间为每10万人每年33例（范围30 - 89例）。
我们发现坦桑尼亚北部布鲁氏菌病发病率中等，表明该疾病在该地区呈地方流行，是一个重要的人类健康问题。
