Epidemiological study of human brucellosis among febrile patients in Erbil-Kurdistan region, Iraq

Abstract

Introduction: Human brucellosis is one of the most common zoonosis infections, with an important impact on the health and economy worldwide. This study aimed to update and provide epidemiological information on this infection and evaluate Rose Bengal Test, which is used as an essential diagnostic test for brucellosis in Erbil. Methodology: A total of 325 participants seeking care and reporting fever at Rizgary Teaching Hospital were enrolled. Blood samples were tested for Brucella spp. antibodies using Rose Bengal Test and blood culture followed by species identification. A questionnaire was administered to detect the risk factors. Results: The prevalence of probable and confirmed brucellosis was 12.3% (95% CI 9.2–16.3) and 9.5% (95% CI 6.8–13.2) respectively. The majority of cases were in the age group of 18-39 years. Brucellosis was significantly associated with raw milk consumption (OR = 10.3 95% CI 5-22.4) and contact with livestock (OR = 11.5 95% CI 5.6-23.9). Brucella melitensis (58.1%) and Brucella abortus (41.9%) are the dominant species in the area. The sensitivity, specificity, positive predictive value, and negative predictive value of the Rose Bengal Test in comparison to the blood culture were 100%, 96.9%, 77.5 %, and 100% respectively. Conclusions: Brucellosis is a significant cause of fever in Erbil and could be diagnosed by the Rose Bengal Test taking into account the compatibility of clinical features with the positive result. The vaccination of livestock and boiling or pasteurization of milk are essential procedures to reduce the frequency of human brucellosis.