Mohamed Ayatullah A, Chehab Mohamad A, Al-Dahshan Ayman, Al-Romaihi Hamad E, Farag Elmoubasher A
Community Medicine, Hamad Medical Corporation, Doha, QAT.
Preventive Medicine, Hamad Medical Corporation, Doha, QAT.
Cureus. 2019 Mar 3;11(3):e4169. doi: 10.7759/cureus.4169.
Introduction Brucellosis is one of the most prevalent bacterial zoonoses and is considered an economically important infection that affects humans and livestock. The infection is usually transmitted to humans through direct contact with infected materials, such as the afterbirth, or indirectly through the ingestion of animal products. In addition, the consumption of raw milk represents a major source of the infection. In the Eastern Mediterranean region, the incidence of brucellosis ranges from one per 100,000 to 20 per 100,000; however, the actual figure is estimated at 20 to 25 times greater owing to the poor surveillance systems among countries in the region. For such reasons, this study is conducted to comprehensively evaluate the brucellosis surveillance system in Qatar, to identify potential strengths and limitations and, hence, inform decision-makers about future mitigation strategies. Methods A retrospective record review was conducted at the surveillance unit in the Ministry of Public Health (MoPH) to analyze all Brucella notification forms from January to November 2018 for the completeness of notification and timeliness of reporting. The principal investigators conducted data abstraction and analysis in November 2018. Results A total of 125 notification forms were analyzed. It was revealed that the internal completeness varied across the different data elements of the notification forms from 39% up to 100%. Also, the timeliness of the reporting ranged from one day for the T3 time point up to 16 days for the T1 time point. Conclusion Ultimately, the strengthening of the national Brucellosis surveillance system in Qatar demands the implementation of several strategies, including the establishment of veterinary surveillance, enforcement of livestock importation protocols, as well as routine compulsory vaccinations, devising a clear and sensitive case definition of the disease, and public education especially among high-risk groups (shepherds, slaughterhouse workers, and laboratory workers). In addition, continuous education of healthcare workers on the proper reporting of the disease and the electronization of the notification process are important steps to improve the surveillance system in the country.
引言
布鲁氏菌病是最常见的细菌性人畜共患病之一,被认为是一种对人类和牲畜具有重要经济影响的感染病。该感染通常通过直接接触受感染的物质(如胎盘)传播给人类,或通过摄入动物产品间接传播。此外,饮用生牛奶是感染的主要来源之一。在东地中海区域,布鲁氏菌病的发病率为每10万人中1例至20例;然而,由于该区域各国监测系统不完善,实际数字估计要高出20至25倍。出于这些原因,开展本研究以全面评估卡塔尔的布鲁氏菌病监测系统,确定其潜在优势和局限性,从而为决策者提供有关未来缓解策略的信息。
方法
在公共卫生部监测部门进行回顾性记录审查,以分析2018年1月至11月所有布鲁氏菌病通报表的通报完整性和报告及时性。主要研究人员于2018年11月进行数据提取和分析。
结果
共分析了125份通报表。结果显示,通报表不同数据元素的内部完整性从39%到100%不等。报告及时性方面,T3时间点为1天,T1时间点为16天。
结论
最终,加强卡塔尔国家布鲁氏菌病监测系统需要实施多项策略,包括建立兽医监测、执行牲畜进口协议以及进行常规强制疫苗接种,制定明确且敏感的疾病病例定义,开展公众教育,特别是在高危人群(牧羊人、屠宰场工人和实验室工作人员)中。此外,持续对医护人员进行关于该疾病正确报告的教育以及通报流程电子化是改善该国监测系统的重要步骤。