Overview of Human Brucellosis in Aseer Region, Saudi Arabia

摘要

Background Brucellosis is a common zoonotic disease of the Middle Eastern countries. Acute cases of brucellosis are often treated as cases of Pyrexia of unknown origin. Aims The main aim of this study is to compare the epidemiological, clinical and laboratory findings of the 42 culture positive cases of Brucella. Methods Forty two culture positive cases of Brucella were obtained from both in -patients and outpatients with a history of pyrexia over a period of two years (Nov 2014-Nov 2016). The patients' files were examined retrospectively for the history, clinical features, and lab findings. Results The prevalence of brucellosis was calculated to be 11.1 per cent as 42 cases were positive for brucellosis out of 377 of PUO cases Of the 42 cultures positive patients the percentage of males (57.1 per cent) were almost equal to the females(42.8 per cent). The mean±S.D age was 28.5±13.65. 28.5 per cent had a history of livestock associations (Chi-square 3.8889, a p-value of 0.048607) which was statistically significant. 26.2 per cent had a history of raw milk and dairy produce intake (Chi-Square 2.6276, p-value of 0.105023) this was not statistically significant. 9.5 per cent had a family history of brucellosis; this association was not statistically significant as well (chi-square statistic 1.8651, p-value of 0.172034). 61.9 per cent presented as acute cases, 30.9 per cent of sub-acute cases and 7.1 per cent as chronic cases respectively. The pre- dominant clinical symptom was Fever (100 per cent) with the commonest clinical signs being the osteoarticular signs (30.9 per cent). Raised ESR and CRP positives were seen in 34 cases (80.9 per cent) and 23 cases (55 per cent) respectively followed by Anaemia in 22 cases (52.3 per cent). Forty two cases were blood culture positive. All the cases were sensitive to the recommended regimen of Doxycycline and streptomycin. Conclusion Brucellosis is still a major health problem in the Middle Eastern countries especially in the Kingdom of Saudi Arabia. Although latest diagnostic equipment are available lacunae in the skill and knowledge prove to be a disadvantage. This scenario may lead to blind treatment which in turn can lead to the development of antibiotic resistance which is another problem altogether.