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International Journal Biomedicine and Public Health Original Article Epidemiological Evaluation of Brucellosis in Isfahan Provin

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International Journal Biomedicine and Public Health Original Article Epidemiological Evaluation of Brucellosis in Isfahan Provin Int J BioMed Public Health. 2019;2(1):14-19 10.22631/ijbmph.2018.126819.1052 International Journal of BioMedicine and Public Health http://www.ijbmph.com Original Article Epidemiological evaluation of brucellosis in Isfahan Province-Iran in 2016 Open Access Elham Karimi-Nazari1,2, Motahareh Sadat Hosseini3, Hossein Jadidi4, Vida Rahimi3, Ali Heidari5* ARTICLE INFO ABSTRACT Article History: Introduction: Brucellosis is one of the most common zoonosis diseases Received 11 April 2018 that can be seen in many developing countries, including Iran. The aim of Revised 30 April 2018 Accepted 4 May 2018 this study was to determine the prevalence of brucellosis in Isfahan province. Keywords: Methods: This is a cross-sectional study in which all newly reported cases Brucellosis of brucellosis in Isfahan city in 2016 were studied. Sampling was done Epidemiology through numerical method. The statistical tests used in this study were one- Iran way ANOVA and two-sample T-test. 1 Nutrition and Food Safety Research Center, Results: The incidence rate of brucellosis in Isfahan province in 2016 was Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran; 19.78 per 100,000. Majority of cases (590, 67.8%) were men with a mean 2 Biological Sciences and Technology Institute, age of 31.62 ± 20.04 years old and 32.2% (280 cases) were women with a Malek Ashtar University of Technology, mean age of 33.35 ± 20.26 years old. Friedan had the highest incidence rate Tehran, Iran; 3 Department of Food Hygiene and Safety, of brucellosis (204.47 per 100,000) while Isfahan had the lowest incidence Faculty of Health, Shahid Sadoughi University rate (1.81 per 100,000). There was a significant relationship between of Medical Sciences, Yazd, Iran; occupational variables (P = 0.001), history of contact with the livestock (P = 4 Research Committee and Department of Biostatistics, School of Public Health, Isfahan 0.0001), non-pasteurized dairy consumption (P = 0.0001), and the incidence University of Medical Sciences, Isfahan, Iran; of the disease (P = 0.003) in urban and rural areas. 5 Zoonotic Diseases Research Center, School of Public Health, Shahid Sadoughi University of Conclusion: The incidence rate of brucellosis in Isfahan is classified as a Medical Sciences, Yazd, Iran. very low. The disease is more common in rural areas than in urban areas. Correspondence: Therefore, educational, preventive and therapeutic measures in rural areas, Ali Heidari. Zoonotic Diseases Research particularly in those involved with animal husbandry and homemaking, Center, School of Public Health, Shahid have priority over urban areas. Sadoughi University of Medical Sciences, Yazd, Iran. [email protected] Introduction strains of the B. melitensis and B. abortus species are the main causes of most human cases (6). This disease Brucellosis also known as waxy fever, Mediterranean is more common in the spring and summer seasons, fever or Malta fever is the most common zoonosis in- which is the birth season of livestock (7). At-risk occu- fectious disease. Human outbreak take place in close pations include animal husbandry, veterinary matters, contact with domestic animals and transmission is work in slaughterhouses, health quality monitoring of occurred directly or indirectly from animals or their meat products and working in bacteriological laborato- products to humans (1, 2). The disease is character- ries. In Iran, brucellosis was separated from a patient’s ized by abortion in animals and by fever, perspiration, blood for the first time in 1912, at the Pasteur Institute. weakness, boredom and weight loss in humans (3). Ac- According to available statistics, the outbreak varies cording to the World Health Organization the disease is in different regions of Iran (8). Based on the findings present in many parts of the world, but most cases are of previous studies, the disease is mainly seen in ru- found in the Mediterranean, Arabian Peninsula, Indian ral regions, and mostly in male gender. Brucellosis is subcontinent, and parts of the central and southern re- more common in younger people who are more social- gions of the United States (4, 5). In our country, various ly active (9). Brucellosis species can survive in frozen This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licens- es/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Epidemiology of brucellosis in Isfahan Province Karimi-Nazari et al. meat for three weeks, in raw milk for ten days, in fresh parison of the demographic data of the patients and cheese for up to three months, and may survive in salt- the incidence of the disease in different age groups as ed meat for a while. Though, smoking, salting, and well as the incidence of the disease according to the freezing contaminated meat significantly reduces the population of counties in 2016 were analyzed. The in- pathogen load. Considering the prevalence of brucel- cidence rate was calculated by dividing the number of losis in the country and its economic burden and com- new cases of disease by 100,000 populations at risk. plications, it is important to consider different aspects The normal distribution of data was assessed using and especially the epidemiology of different parts of Kolmogorov-Smirnov test and the Mann-Whitney and the country. This study was conducted to evaluate epi- Kruskal-Wallis tests were used for the comparison demiology of brucellosis in Isfahan province in 2016. of non-parametric data while independent t-test and one-way analysis of variance (ANOVA) were used for Methods comparison of parametric data. The significance level was considered as P <0.05. The present study is a cross sectional study which re- cruited all patient with clinical symptoms compatible Results with brucellosis in 95 cities of Isfahan Province-Iran. The epidemiological data of suspected and definite cas- A total of 870 new cases or recurrent febrile illnesses es (having all diagnostic criteria for brucellosis) cases were reported in Isfahan Province in 2016. Majority of were recorded. Suspicious brucellosis was defined as cases (590, 67.8%) were male and 32.2% (280 cases) having positive history of contact with animals or ani- were female. Majority of cases were in the age group mal products or positive Wright test titration (equal or of 20-30 years (Figure 1). Most of the cases (462, greater than 1.80). All patients, in addition to having 53.1%) were rural residents while 37.1% (323 cases) clinical symptoms, had a positive serology (Burning were urban residents while 1.3% (11 cases) had no- 1.8 and 2ME more than 1.4) for brucellosis. Since bru- madic lifestyle and the residency status of 8.5% (74 cellosis is not considered as urgently reported illnesses, cases) was unspecified. The distribution of new cases diagnosis is documented by a specialist and through of brucellosis in Isfahan province as per demographic laboratory examination each month. Therefore, all and habitat categories in year 2016 is presented in table data for brucellosis cases are saved in the provincial 1. This study showed that the number of cases of bru- health care center archive. In this study, the informa- cellosis in the winter and summer seasons were more tion regarding all reported cases of brucellosis during than autumn and spring. One-way ANOVA showed the year 2016 was collected and categorized. Data that the disease level was significantly different in dif- analysis was performed using the statistical package ferent seasons (P = 0.003). There was a significant re- for social sciences (SPSS) software version 16. Com- lationship between occupational variables, age, histo- Figure 1. Age distribution of brucellosis cases in Isfahan Province in 2016 Int J BioMed Public Health. 2019;2(1):14-19 DOI:10.22631/ijbmph.2018.126819.1052 http://www.ijbmph.com 15 Epidemiology of brucellosis in Isfahan Province Karimi-Nazari et al. ry of contact with livestock, history of non-pasteurized per 100,000. In the study by Farahani et al. (10) in Arak, dairy consumption, and seasonal incidence in urban the incidence of the disease was 60 per 100,000, which and rural areas (P <0.05). The incidence rate of brucel- was higher than the observed incidence in our study. In losis in Isfahan province in 2016 was 1.81 per 100,000. general, and based on a global standard, the prevalence The highest incidence rate was observed in Friedan of brucellosis in each country depends very closely on city (204.47 per 100,000) and Boeing and Miandasht the incidence of disease in its livestock (2). One of the (185.52 per 100,000) (Table 2). Figure 2 presents inci- important reasons for the geographical difference in the dence rate of brucellosis in cities of Isfahan province. incidence of brucellosis is likely to be the variation in The maximum number of reported cases were reported the prevalence of the disease in the livestock in differ- in Faryad (170 cases) and Najafabad (148 cases). The ent regions. Majority of cases (67.8%) were men and number of cases of brucellosis in months of the year is 32.2% were women. This finding was consistent with presented in Figure 2. The maximum number of bru- the results of a number of other studies in this regard. cellosis cases was reported in March (180 cases) and The study by Elbeltagy in Saudi Arabia and Farahani the minimum number of cases was reported in Decem- in Arak, Iran also reported higher incidence rates of the ber (39 cases). illness among men (10, 11). In contrast to the findings of our study in a study by Haddadi et al.
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