Dadar Maryam, Al-Khaza'leh Ja'far, Fakhri Yadolah, Akar Kadir, Ali Shahzad, Shahali Youcef
Razi Vaccine and Serum Research Institute (RVSRI), Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran.
Faculty of Agricultural Technology, Al-Balqa Applied University, P.O. Box 19117, Al-Salt, Jordan.
Heliyon. 2024 Jul 9;10(14):e34324. doi: 10.1016/j.heliyon.2024.e34324. eCollection 2024 Jul 30.
Human brucellosis, caused by the bacteria , is a significant infectious disease globally, also known as Mediterranean fever or Malta fever.
This meta-analysis and systematic review focuses on the prevalence rate, risk factors, and diagnostic methods of human brucellosis in Middle Eastern countries, where the disease remains a significant public health issue. The analysis included 92 studies conducted between 1993 and 2024, following specified inclusion and exclusion criteria among symptomatic patients across these countries. The prevalence rate was calculated by dividing positive samples by total samples. The I2 index and Chi-squared test assessed study heterogeneity. Significant heterogeneity occurred when I2 exceeded 50 %.
The highest prevalence rate was observed in Oman, Lebanon, and Kuwait countries, emphasizing a notable burden of infection in these regions. Risk factors associated with human brucellosis were identified, with unpasteurized dairy consumption and close animal contact being predominant. Various professions such as farmers, dairy factory workers, and agriculture workers showed higher prevalence rate. Gender analysis indicated a prevalence rate of 18.02 % (95 % CI: 11.55-25.51 %) in males and 13.61 % (95 % CI: 10.8-16.68 %) in females, with no significant difference in hospitalization rates. The prevalence rate of spp. was varied across detection methods, with immunocapture agglutination assay (Brucellacapt) showing the highest estimated prevalence rate of (44.04 %, 95 % CI: 27.71-61.04), followed by PCR (39.84 %, 95 % CI: 20.14-61.39) and culture (29.22 %, 95 % CI: 17.89-42.03). Among species, and were the highest prevalence rate. Although statistically insignificant, the meta-analysis also revealed an upward trend in prevalence rate from 1993 to 2024, (P value = 0.277).
This comprehensive review emphasizes the need for tailored strategies to control brucellosis in the Middle East, highlighting the importance of timely diagnosis, public awareness, and effective treatment protocols. These findings provide valuable insights for policymakers and healthcare professionals working to mitigate the impact of this disease in the region.
由细菌引起的人类布鲁氏菌病是全球一种重要的传染病，也被称为地中海热或马耳他热。
这项荟萃分析和系统评价聚焦于中东国家人类布鲁氏菌病的患病率、危险因素和诊断方法，在这些国家该疾病仍是一个重大的公共卫生问题。该分析纳入了1993年至2024年期间在这些国家有症状患者中按照特定纳入和排除标准开展的92项研究。患病率通过阳性样本数除以总样本数来计算。I²指数和卡方检验评估研究的异质性。当I²超过50%时存在显著异质性。
在阿曼、黎巴嫩和科威特等国观察到最高患病率，凸显了这些地区感染的显著负担。确定了与人类布鲁氏菌病相关的危险因素，其中食用未巴氏杀菌的乳制品和与动物密切接触最为突出。农民、乳制品厂工人和农业工人等各类职业的患病率较高。性别分析表明，男性患病率为18.02%（95%置信区间：11.55 - 25.51%），女性患病率为13.61%（95%置信区间：10.8 - 16.68%），住院率无显著差异。不同检测方法检测到的 菌属患病率各不相同，免疫捕获凝集试验（Brucellacapt）显示估计患病率最高（44.04%，95%置信区间：27.71 - 61.04），其次是聚合酶链反应（PCR）（39.84%，95%置信区间：20.14 - 61.39）和培养法（29.22%，95%置信区间：17.89 - 42.03）。在 菌属中， 和 的患病率最高。尽管在统计学上无显著意义，但荟萃分析也显示1993年至2024年患病率呈上升趋势（P值 = 0.277）。
这项全面综述强调需要制定针对性策略来控制中东地区的布鲁氏菌病，突出了及时诊断、公众意识和有效治疗方案的重要性。这些发现为致力于减轻该疾病在该地区影响的政策制定者和医疗保健专业人员提供了宝贵的见解。
