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坦桑尼亚卡盖拉生态系统中布鲁氏菌病与人类和家养反刍动物流产的关联

Association of brucellosis to abortions in humans and domestic ruminants in Kagera ecosystem, Tanzania.

作者信息

Ntirandekura Jean-Bosco, Matemba Lucas Eliaimringi, Kimera Sharadhuli Iddi, Muma John Bwalya, Karimuribo Esron Daniel

机构信息

Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.

Département de Santé et Productions Animales, Faculté d'Agronomie et de Bio-Ingénierie, Université du Burundi, Bujumbura, Burundi.

出版信息

Transbound Emerg Dis. 2020 Sep;67(5):1879-1887. doi: 10.1111/tbed.13516. Epub 2020 Feb 29.

Abstract

Brucellosis is a worldwide zoonotic disease of socio-economic importance. Understanding the association of this disease with pregnancy outcome has the potential of contributing to the reduction of its reproductive burden in humans and animals among pastoral communities in Tanzania. A prospective cohort study was conducted in Kagera Region on pregnant women (n = 76) and gravid ruminants (121 cattle, 125 goats and 111 sheep). Exposed and non-exposed groups to brucellosis were followed for 6 months (from 15 November 2017 to 15 April 2018). Sera were collected and analysed using Rose Bengal Test (RBT) and Fluorescence polarization assay (FPA) test. Measures of effect, univariable and multivariable logistic regression analyses were computed. Positivity to both RBT and FPA tests was 21% (95% CI: 12.5-32) in pregnant women and 5% (95% CI: 3.1-8) in gravid ruminants. Among aborted cases, four women (out of nine), two cows (out of seven), two goats (out of 26) and zero sheep (out of 11) were positive to brucellosis. The abortion rate in humans and ruminants was 11.8% and 12.3%, respectively. Seropositivity to brucellosis was similar in aborted and non-aborted cases in humans (p = .08) and in ruminants (p = .2). At the population level, brucellosis was associated with abortions (population attributable risk: PAR) at 3.5% in pregnant women and at 0.5% in gravid ruminants in the study area. Infections to brucellosis were increased in exposed pregnant women (OR = 19; 95% CI: 1.8-203, p = .01) and in cattle (OR = 11; 95% CI: 1.3-88, p = .02). There is an indication that brucellosis could be contributing to abortions in pregnant women and domestic ruminants Kagera Region. Molecular tools could support more the results from serological tests to avoid cross-reaction with other pathogen agents. Control of brucellosis in animals is likely to reduce the threat of abortions in humans.

摘要

布鲁氏菌病是一种具有社会经济重要性的全球性人畜共患病。了解这种疾病与妊娠结局之间的关联,有可能有助于减轻其在坦桑尼亚牧区人群和动物中的生殖负担。在卡盖拉地区对孕妇(n = 76)和妊娠反刍动物(121头牛、125只山羊和111只绵羊)进行了一项前瞻性队列研究。对布鲁氏菌病暴露组和非暴露组进行了6个月的随访(从2017年11月15日至2018年4月15日)。采集血清并使用玫瑰红试验(RBT)和荧光偏振测定法(FPA)进行分析。计算了效应量、单变量和多变量逻辑回归分析。孕妇中RBT和FPA试验的阳性率为21%(95%CI:12.5 - 32),妊娠反刍动物中为5%(95%CI:3.1 - 8)。在流产病例中,9名女性中有4名、7头牛中有2头、26只山羊中有2只、11只绵羊中0只为布鲁氏菌病阳性。人类和反刍动物的流产率分别为11.8%和12.3%。人类流产和未流产病例中布鲁氏菌病血清阳性率相似(p = 0.08),反刍动物中也相似(p = 0.2)。在人群层面,在研究地区,布鲁氏菌病与流产相关(人群归因风险:PAR),孕妇中为3.5%,妊娠反刍动物中为0.5%。暴露的孕妇(OR = 19;95%CI:1.8 - 203,p = 0.01)和牛(OR = 11;95%CI:1.3 - 88,p = 0.02)感染布鲁氏菌病的几率增加。有迹象表明,布鲁氏菌病可能导致卡盖拉地区孕妇和家养反刍动物流产。分子工具可能更有助于支持血清学检测结果,以避免与其他病原体发生交叉反应。控制动物中的布鲁氏菌病可能会降低人类流产的威胁。

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