Department of Epidemiology and Biostatistics, Key Laboratory of Zoonosis, Ministry of Education, School of Public Health, Jilin University, Changchun, People's Republic of China.
Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China.
Emerg Microbes Infect. 2023 Dec;12(1):2185464. doi: 10.1080/22221751.2023.2185464.
Balancing the potentially serious outcomes of asymptomatic brucellosis and "waiting" for treatment in clinical practice is an urgent issue. Therefore, we assessed the follow-up outcomes and epidemiological characteristics of asymptomatic brucellosis in the absence of treatment to provide evidence-based clinical clues. We searched eight databases in which 3610 studies from 1990 to 2021 were related to the follow-up outcomes of asymptomatic brucellosis. Thirteen studies, involving 107 cases, were finally included. Regarding the follow-up outcomes, we examined the presence or absence of symptoms and decreased serum agglutination test (SAT) titre. During the 0.5-18 months follow-up period, the pooled prevalence of appearing symptomatic was 15.4% (95% CI 2.1%-34.3%), cases that remained asymptomatic were 40.3% (95% CI 16.6%-65.8%), and decreased SAT titre was observed in 36.5% (95% CI 11.6%-66.1%). Subgroup analysis indicated that the pooled prevalence of appearing symptomatic with follow-up times of less than 6 months, 6-12 months, and 12-18 months was 11.5%, 26.4%, and 47.6%, respectively. The student subgroup had a higher prevalence of symptoms (46.6%) than the occupational and family populations. In conclusion, asymptomatic brucellosis has a high likelihood of appearing symptomatic and its severity may be underestimated. Active screening of occupational and family populations should be enhanced, and special attention should be paid to high-titre students for early intervention, if necessary. Additionally, future prospective, long-term, and large-sample follow-up studies are essential.
平衡无症状布鲁氏菌病的潜在严重后果和在临床实践中“等待”治疗是一个紧迫的问题。因此，我们评估了无症状布鲁氏菌病在未经治疗的情况下的随访结果和流行病学特征，为临床提供循证线索。我们检索了 1990 年至 2021 年的 8 个数据库，其中有 3610 项研究与无症状布鲁氏菌病的随访结果有关。最终纳入了 13 项研究，共 107 例。关于随访结果，我们检查了症状的存在或不存在以及血清凝集试验（SAT）滴度的降低情况。在 0.5-18 个月的随访期间，出现症状的总患病率为 15.4%（95%CI 2.1%-34.3%），无症状持续存在的病例占 40.3%（95%CI 16.6%-65.8%），SAT 滴度降低的病例占 36.5%（95%CI 11.6%-66.1%）。亚组分析表明，随访时间小于 6 个月、6-12 个月和 12-18 个月时出现症状的总患病率分别为 11.5%、26.4%和 47.6%。学生亚组的症状患病率（46.6%）高于职业和家庭人群。总之，无症状布鲁氏菌病有很大可能出现症状，其严重程度可能被低估。应加强对职业和家庭人群的主动筛查，对高滴度学生应特别注意，必要时进行早期干预。此外，未来需要进行前瞻性、长期和大样本的随访研究。
