Conference abstract

Epidemiological aspects of Brucellosis in the center of Tunisia: which features in 2016

Pan African Medical Journal - Conference Proceedings. 2017:4(45).26 Dec 2017.
doi: 10.11604/pamj-cp.2017.4.45.249

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Keywords: Brucellosis, epidemiology, Tunisia
Abstract

Epidemiological aspects of Brucellosis in the center of Tunisia: which features in 2016

Wafa Marrakchi1,&, Ikbel Kooli1, Hajer Ben Brahim1, Abir Aouam1, Chawki Loussaief1, Adnene Toumi1, Mohamed Chakroun1

1Department of Infectious Diseases, Fattouma Bourguiba University Hospital, Monastir, Tunisia

&Corresponding author
Wafa Marrakchi, Department of Infectious Diseases, Fattouma Bourguiba University Hospital, Monastir, Tunisia

Abstract

Introduction: Brucellosis is a highly contagious zoonosis with high morbidity in human. The objective of this study is to describe epidemiological and clinical aspects and therapeutic outcomes of brucellosis in an endemic region.

Methods: retrospective study performed between 1996 and 2016 in the center of Tunisia in which adult patients with active brucellosis referred to the Department of Infectious Diseases were chosen.

Results: thirty one cases were included, the mean age was 41,8 years (5 to 83 years). A female predominance was observed (F: M sex ratio, 1,2). Of them, 74,2% were diagnosed as acute (n = 23) and 25,8% as sub-acute brucellosis (n = 8). Risk factors were consumption of unpasteurized milk and dairy products (n = 29, 93,5%) and risky profession (n = 9, 29%). Among them, we noted eight farmers and one veterinary. Family history was positive for brucellosis in five cases (16,1%). The most common complaint was fever in 26 cases (84%). Spondylodiscitis was the most common form of presentation of sub-acute brucellosis (n = 2, 25%). The average time limit of consultation was 37,6 days (2-240 days) for acute brucellosis and 55,5 days (21-120 days) for sub-acute brucellosis. In all cases agglutination tests were positive. At enrolment, Wright test was positive in 30 cases (96,7%) with an average of 1833,6UI/ml (60-17220 UI/ml). Elevated liver enzymes was observed in 6 cases (19,3%) and leucopenia in 4 cases (13%). The C-reactive protein and sedimentation rate were evaluated with an average of 21,7 mg/l and 50 mm, respectively. Doxycyline and rifampicin combination during 6 weeks was the most preferred therapy protocol (61,3%). Relapse was detected in 2 cases.

Conclusion: despite the efforts to reduce the incidence of brucellosis, it is still an important health problem in Tunisia. Early detection and prompt treatment can provide rapid recovery and prevent complication or sequels.