Risk factors for human brucellosis in Iran: a case-control study.

BACKGROUND: Brucellosis is a zoonotic disease of worldwide distribution. Despite its control in many countries, it remains endemic in Iran. The aim of this study was to determine the risk factors for brucellosis acquisition in the central province of Iran. METHODS: A matched case-control study was conducted in the central part of Iran. A total of 300 subjects (150 cases and 150 controls) were enrolled in the investigation. Brucellosis cases were defined on the basis of epidemiologic, clinical, and laboratory criteria. Subjects were interviewed using a questionnaire to obtain risk factor information. We used odds ratios and conditional logistic regression models to explore the association between the disease and the variables studied. RESULT: Significant risk factors for infection were related to the existence of another case of brucellosis in the home (OR=7.55, p=0.0001) and consumption of unpasteurized dairy products (OR=3.7, p=0.014). Keeping cattle and cattle vaccination were also important risk factors. CONCLUSIONS: Pasteurization of dairy products and education regarding fresh cheese must be pursued for eradication of brucellosis. A major risk factor for acquiring brucellosis is the existence of another infected family member. Therefore screening family members of an index case of brucellosis may lead to the detection of additional cases.     

Childhood brucellosis in Babol, Iran

This prospective study was conducted on 111 children with brucellosis, who attended the Department of Infectious Diseases, Babol, Iran, from September 1999 to March 2003. Fever (73.9%), sweating (67.6%), artheralgia (49.5%) and splenomegaly (18%) were common findings. The disease was acute and sub-acute in 97.3% and chronic in 2.7% of cases. Peripheral arthritis was seen in 35 (31.5%) of cases, which was monoarticular in 29 patients, most involving the knees and hips. Sacroilitis was seen in six (5.4%) cases.     

Epidemiological and clinical aspects of human brucellosis in Central Greece

The confirmed cases of human brucellosis in the area of Larissa in Central Greece from 2003 to 2005 were analyzed to assess the features of the affected population and to determine the factors influencing the acquisition of infection. Data of patients infected by Brucella spp. concerning age, gender, occupation, date of diagnosis and the observed symptoms were collected from regional hospitals, health centres and private practitioners. The incidence of human brucellosis in the area was 32.49 cases/100,000 inhabitants. Males, due to their professions, were affected more often by brucellosis than females. The majority of the cases were attributed to direct contact with animals or their products. Only in 8.49% of the cases was the infection attributed to the consumption of dairy products. The urban population is not at potential risk for acquiring brucellosis because all commercialized dairy products in Greece are produced from pasteurized milk. The occurrence of human brucellosis shows seasonality, with the majority of the cases diagnosed from December to May. Direct contact with animals, the season of the year and gender were the risk factors influencing the acquisition of infection. Fever, arthralgia, profuse sweating and anorexia were the symptoms most often observed.     

2004-2009年宁夏人间布鲁杆菌病流行病学分析

目的 了解宁夏布鲁杆菌病(简称布病)的流行规律及趋势,为采取科学有效的防治措施提供依据.方法 2004-2009年,对宁夏银川市、石嘴山市、吴忠市、固原市和中卫市五地市网络报告的布病患者的资料进行整理和回顾分析,资料内容包括人口学特征、就诊情况及病史病程等方面信息,分析指标包括报告发病率;患者的性别、年龄、地区分布、城乡分布情况;转为慢性期率及其影响因素;病例报告单位的分布情况等.结果 2004-2009宁夏累计报告布病349例,无死亡病例,年报告发病率分别为0.017/10万、0.543/10万、0.151/10万、0.563/10万、1.771/10万、2.692/10万;男女比约为5.5∶1(295/54);≥30岁年龄组所占比例相对较高(27.5%,96/349);患者职业分布主要以农牧民为主(70.2%,245/349);在布病患者人数的地区分布中,吴忠市所占比例最高(61.9%,216/349),其次为银川市(22.9%,80/349);农村的布病患者所占比例(97.4%,340/349)高于城市(2.6%,9/349);患者转为慢性期的比例为11.2%(39/349),随着年龄的增长,布病转为慢性期的机会有减少的趋势(优势比为0.966);疾病预防控制中心报告病例占74.8%(261/349),医院报告的病例占25.2%(88/349).结论 宁夏人间布病发病率呈逐年快速上升趋势,发病主要以男性青壮年为主,转慢率较高,医院发现报告病例的能力较弱.应采取综合措施,加大经费投入、加强监测、不断提高医务人员诊断意识和水平,进一步加强对布病的预防控制.

Abstract：

Objective To learn the prevalence and trends of Brucella disease in Ningxia, in order to provide scientific basis for effective control of the disease. Methods Data of Brucella cases reported through city network from 2004 to 2009 in Yinchuan city, Shizuishan city, Wuzhong city, Guyuan city and Zhongwei city of Ningxia were reviewed and retrospectively analyzed. The data included demographic characteristics, treatment conditions and medical history so on related information. Analytical indicators include reported incidence;with patients' gender, age, regional distribution, urban and rural distribution;become chronic and associated factors;distribution of the cases reporting unit and so on. Results From 2004 to 2009, Ningxia had reported 349 cases of Brucellosis, no deaths, the annual incidence rates reported were 0.017/10 million, 0.543/10 million, 0.151/101 (295/54);The proportion of 34- to 40-year-old age group was higher than other age groups(27.5%, 96/349);Occupational distribution of patients was mainly farmers and herdsmen(70.2% ,245/349), in regional distribution of the patients, the highest percentage was Wuzhong city(61.9%,216/349), followed by Yinchuan city(22.9%,80/349);The proportion of patients in rural areas(97.4% ,340/349) was higher than urban(2.6% ,9/349);the proportion of patients converted to chronic was 11.2% (39/349). With age, the chance of patients converted to chronic was in a decreasing trend(odds ratio was 0.966);cases reported by Centre for Disease Control and Prevention accounted for 74.8%(261/349), by hospital accounted for 25.2%(88/349). Conclusions The reported incidence of Brucellosis in Ningxia is in a rapid upward trend year by year, the patients is mainly young men, the rate of converted to chronic is higher and the ability of hospital in founding and reporting of the cases is weaker.Comprehensive measures should be taken to increase funding, strengthen monitoring, and continuously improve the level of awareness and diagnosis of medical personnel for further strengthen the prevention and control of Brucellosis.     

Epidemiological and molecular aspects of ovarian cancer risk

In Western and Northern Europe, as well as in the United States, ovarian cancer represents the third most frequent cancer of the female genital tract with an estimated 191,000 newly diagnosed cases per year worldwide. Due to its insidious onset, the disease is diagnosed in 70% of cases in an advanced stage. Consequently, ovarian cancer is the fifth leading cause of cancer-related deaths in women. Epidemiological and molecular studies reviewed here have identified demographic, geographic, molecular, genetic, endocrine, dietary, and environmental factors, which affect the risk of developing ovarian cancer: ethnic background, tumor suppressor gene mutations in the germline, positive family history, number of full-term pregnancies [odds ratio (OR): 0.17; 95% confidence interval (CI): 0.05–0.54], time spent breast feeding, oral contraceptive use [OR: 0.23; 95% CI: 0.10.50], unexplained infertility (OR: 2.64; 95% CI: 1.10–6.35), tubal ligation and prior hysterectomy (OR: 0.5; 95% CI: 0.2–0.9), dietary factors and obesity (OR: 1.7; 95% CI: 1.1–2.8). This knowledge provides the objective basis for an individual risk assessment for women, which should lead to sophisticated counseling and prevention. It should also help to individualize the therapeutic approach in the event that disease is diagnosed. Received: 20 March 2000 / Accepted: 18 April 2000     

保定市1994～2004年人间布氏菌病流行特点及分析

目的 分析保定市1994～2004年人间布氏菌病流行特点，为布氏菌病防治提供科学依据。方法 收集1994～2004年本市布氏菌病患者个案资料进行分析。结果 发病人数显著增加；发病以从事羊只饲养、屠宰、皮毛加工人员为主；4～8月份为发病高峰；发病至确诊间隔时间长，及时诊断率低。结论 保定市人间布氏菌病疫情有上升趋势，局部地区存在布氏菌病暴发流行的可能性。     

2008-2018年陕西省人间布鲁氏菌病流行特征分析

目的 了解2008-2018年陕西省人间布鲁氏菌病的发病特征及流行态势,为进一步制定布鲁氏菌病防控措施提供科学依据。方法 采用描述性流行病学方法,对 2008-2018 年陕西省布病疫情资料进行统计分析。结果 2008-2018年陕西省共报告布鲁氏菌病病例10 007例,年发病率在 1.55 /10 万 ~ 4.08 /10 万之间,平均发病率为2.41/10万,不同年份发病率差异有统计学意义(P<0.001),无死亡病例;病例主要集中在陕北和关中地区,以榆林市、延安市和渭南市为多发地区,占86.23%,陕南地区病例数较少;全年均有报告,4~7月为发病高峰;发病以40~59岁年龄组为主,占发病总数的50.19%;男性多于女性,男女发病比为3.57∶1;职业分布以农民为主,占 89.44%。血清学平均阳性率为4.21%。布病发病至诊断时间间隔的中位数是22 d。结论 陕西省布鲁氏菌病防控形势依然严峻,流行在未来一段时间呈持续状态,应加强传染源的管理,加大布鲁氏菌病监测力度,做好布鲁氏菌病的防控工作。     

Gestational diabetes in Iran: incidence, risk factors and pregnancy outcomes

The objective of this study was to determine the incidence of gestational diabetes mellitus (GDM) and compare fetal, maternal and neonatal complications amongst women with GDM and pregnant women with normal glucose tolerance in an urban Iranian population. In a prospective cohort study, universal screening for gestational diabetes mellitus was performed for 1310 pregnant women who were referred from private clinics and community health care centers to Fatemiyeh Hospital in Shahrood City. Screening was performed with a 50 g oral Glucose Challenge Test (GCT) with 130 mg/dl cut-off point, then a diagnostic 100 g Oral Glucose Tolerance Test (OGTT) was done according to Carpenter and Coustan criteria. The incidence of GDM was 4.8%. There were differences in risk factors: age >30 years, family history of diabetes, obesity, previous macrosomia, glycosuria between the two groups (P<0.001). Women with GDM had a higher rate of stillbirth (P<0.001; odds ratio 17.1, 95% CI=4.5-65.5), hydramnios (P<0.001; odds ratio 15.5, 95% CI=4.8-50.5), gestational hypertension (P<0.001; odds ratio 6, 95% CI=2.3-15.3), macrosomia (P<0.05; odds ratio 3.2, 95% CI=1.2-8.6) and caesarean section (P<0.001). We have found that the incidence of GDM in an urban Iranian population is similar to developed countries. Complications were more common in the GDM group than in the normal group and outcomes for women with persistent diabetes post-partum were particularly poor. We recommend screening for GDM in Iran, but further evaluation of selective screening and cost effectiveness will need to be performed. Measures to improve the outcome of GDM pregnancy will also need to be addressed in the future.     

安阳市1997～2001年人间布氏菌病流行特点及分析

目的分析安阳市1997～2001年人间布氏菌病流行特点,为布氏菌病防治提供科学依据。方法收集1997～2001年本市布氏菌病患者个案资料进行分析。结果发病人数显著增加;发病以从事羊、牛饲养的人员为主;4、5月份为发病高峰;发病至确诊间隔时间长,及时诊断率低,误诊率高。结论安阳市人间布氏菌病疫情有上升趋势,局部地区存在布氏菌病暴发流行的可能性。     

2010年内蒙古乌兰察布市布鲁杆菌病流行病学调查

目的 了解内蒙古乌兰察布市布鲁杆菌病(布病)发病情况,为制定防治措施提供依据.方法 2010年11-12月,按照《内蒙古自治区人间布鲁氏菌病基线调查方案》中的要求,采取分层整群等量抽样调查方法,在全市的11个旗(市、县、区)按布病病情各抽取轻、中、重3个乡镇(苏木),每个乡镇(苏木)抽取3个村或嘎查,每个乡镇(苏木)至少调查200人,年龄≥10岁,每个旗(市、县、区)至少调查600人.对被调查者进行健康教育问卷调查和临床诊断.问卷调查包括对布病基本知识、布病危险因素、布病防治常识的了解.临床诊断确诊是否是疑似病例.根据知情同意的原则,采集被调查者静脉血,初筛用虎红平板试验,确诊用标准试管凝集试验,抗体滴度1∶100(++)及以上为阳性,统计布病感染率.参照2010年乌兰察布市布病33个乡镇(苏木)的网报结果,统计患病率、漏报率以及不同年龄、性别、职业的发病率.结果 共下发调查问卷6998份,有效卷数6763份.布病基本知识知晓率为57.99％(15 687/27 052),布病危险因素知晓率为44.33％(29 978/67 630),布病防治常识知晓率为41.66％(28 176/67 630),总知晓率为45.49％(73 841/162 312).血清学检查阳性591人,感染率为8.48％(591/69 972).确诊布病患者903例,患病率为105.13/万(903/85 894);33个乡镇(苏木)网报新发病例数/年为785例,发病率/年为91.39/万(785/85 894);漏报病例数/年为377例,漏报率/年为48.03％(377/785).男性感染率为71.07％(420/3755),女性感染率为28.93％(171/3217),31岁以上感染率(97.63％,577/591)明显高于30岁以下(2.37％,14/591).养殖业感染率为8.61％(582/669),畜产品加工业感染率为2.91％(2/103),畜产品流通业感染率为2.85％(2/70),其他行业感染率为4.59％(5/109).结论 乌兰察布市布病发病率较高,漏报率较高,养殖业感染率高,青壮年发病多,男性发病多,布病防治知识知晓率低.应有针对性地开展健康教育宣传,提高病区居民自我保护意识,降低布病的发生.     

Seroprevalence of brucellosis in slaughterhouse workers in Kerman city,Iran

ObjectiveT o evaluate the seroprevalence of brucellosis among the risk group of population between the periods from July 2011 to June 2011.MethodsA total of 75 sera samples of Kerman slaughterhouse workers were collected. Sera were tested by a commercial indirect ELISA kit.ResultsThe apparent seroprevalence was 58.6% by ELISA method. Significant relation were observed with clinical signs (P<0.001) and duration of work (P<0.01) but relation between age, job title and education level with seropositivity were not significant.ConclusionsThe study indicates that the slaughterhouse workers in Kerman City are at high risk to infection with brucellosis.     

福建省2008-2017年人间布鲁氏菌病流行特征及分离株MLVA分型研究

目的 探讨福建省人间布鲁氏菌病流行特征,并对其分离株进行分子分型,为制定预防控制策略提供依据。方法 收集中国疾病预防控制信息系统中2008-2017年福建省布鲁氏菌病报告数据,进行流行特征分析;采用传统生物学鉴定和BCSP31-PCR、AMOS-PCR、MLVA-16进行布鲁氏菌分离株分子鉴定和分型,并进行聚类分析。结果 福建省2008-2017年布鲁氏菌病发病呈逐年上升趋势,年均发病率0.11/10万;疫情波及福建省80%的县区,呈高度散发态势;发病高峰为4-8月;40~64岁发病数占62.7%,60~64岁组发病率最高(0.27/10万);男女比为2.50:1,农牧民占50.7%。40株布鲁氏菌分离株分子检测结果与传统分型基本相符,为2个种(羊种和猪种)和2个生物型(羊3型和猪3型),其中羊种布鲁氏菌占绝大多数(87.5%); MLVA-16分型将其分为羊种和猪种2个种群,35株羊种菌分为28种基因型,5株猪种菌分为4种基因型,其中26种基因型为单分离株,6种基因型为共享基因型(共14株,35.0%)。同国内147株布鲁氏菌进行聚类分析显示,福建省菌株与广东和内蒙古地区存在4种共享基因型,均为羊种菌,其他部分菌株与外省菌株存在着较近的遗传距离,主要集中在panel 2B上,仅存在1~3个位点的差异。结论 福建省布鲁氏菌病流行强度逐年增高,建议相关部门加强传染源的管控、对疫情高发地区的重点人群采取必要防控措施,控制其发生与流行。福建省布鲁氏菌MLVA-16分型显示高度基因多态性,提示MLVA-16可用于遗传多样性分析和分子流行病学溯源调查,可以提高布鲁氏菌病监测能力。     

Sero-prevalence of brucellosis among blood donors in Ahvaz,Southwest Iran

ObjectiveTo identify sero-prevalence of brucellosis among blood donors in Ahvaz city, Southwest Iran.MethodsA total number of 1 450 serum samples from blood donation were collected and were screened for the presence of brucella antibody. Rose Bengal Plate Test, Standard Agglutination Test (SAT), and 2-mercaptoethanol (2ME) agglutination were tested in the sample. SAT dilution ≥1/80 and 2ME agglutination ≥1/40 were considered positive.ResultsSero-prevalence of brucellosis among the blood donors was 0.70%, 0.34%, and 0.20% by Rose Bengal Plate Test, SAT, and 2ME respectively.ConclusionsConsidering the 1/80 titer of SAT as the criteria of contamination with brucella, routine screening of sero-prevalence of brucella in blood donors is not recommended in this area.     

自贡市2016-2021年布鲁氏菌病暴发疫情特征分析

目的 分析自贡市2016-2021年布鲁氏菌病暴发疫情特点,为非牧区布病聚集性疫情控制提供依据。方法 对2016-2021年自贡市布鲁氏菌病暴发进行现场调查,筛查重点及高危人群和涉及牲畜,分析疫情发生原因及特点,采取相应控制措施。结果 2016-2021年共报告4起布鲁氏菌病本地暴发疫情,涉及20例患者。病例共同暴露者筛查阳性率14.67%(11/76),畜间血清学筛查阳性率16.67%(19/114);MLVA分析显示分离到菌株与北京、宁夏分离菌株同源性为90.6%。结论 2016-2021年自贡布病疫情传染源均为病羊,食用未煮熟羊肉、私下引种(交易)山羊及无防护屠宰加工是引起布鲁氏菌病暴发的主要原因,应强化国内重点地区牲畜引种、畜产品交易的检疫力度,加强对职业人群的监测工作,开展重点人群的知识宣传。     

Epidemiological characteristics and shortterm epidemiological trend prediction of human brucellosis in Baotou City,Inner Mongolia,2003-2017

<正>Objective To analyze the epidemiological characteristics of human brucellosis in Baotou City,Inner Mongolia in 2003-2017,conduct short-term forecasting of incidence of brucellosis in 2018-2020,and provide evi-     

陕西省陕南地区一起人间布鲁氏菌病暴发疫情的调查研究北大核心CSCD

目的调查2021年陕西省陕南地区一起人间布鲁氏菌病(简称布病)暴发疫情的原因,为今后该地区布病疫情防控提供借鉴依据。方法通过现场流行病学调查和实验室检测,对2021年7月份商洛市丹凤县龙驹寨鹿池社区一起布病暴发疫情进行传染源追踪调查和传染途径分析。结果共发现5例确诊病例、6例隐性感染者和1例疑似病例,病例性别比为3∶1,发病到确诊时间间隔87~123 d,中位数为119 d,临床表现以发热为主;12例病例血清抗体滴度从1∶50(++)到1∶1600(++)不等;病例感染途径与清理圈舍有关联(OR=6.4,95%CI:1.195~34.285);畜间检测结果显示53只羊和2只犬均为布病阳性。结论该起布病暴发疫情的主要原因是未及时清理羊只粪便、未定期对圈舍和生活居住环境进行消毒,导致养殖户及其家人、雇工等相继感染布病,建议畜牧部门调整陕南地区人间布病重点地区的牲畜免疫政策,同时人畜间联合加强圈舍、生活居住等环境消毒及个人防护等养殖科学卫生知识的宣传教育。