Brucellosis in low-income and middle-income countries.
Abstract
PURPOSE OF REVIEW: Human brucellosis is a neglected, underrecognized infection of
widespread geographic distribution. It causes acute febrile illness and a potentially
debilitating chronic infection in humans, and livestock infection has substantial
socioeconomic impact. This review describes new information regarding the epidemiology
of brucellosis in the developing world and advances in diagnosis and treatment. RECENT
FINDINGS: The highest recorded incidence of human brucellosis occurs in the Middle
East and Central Asia. Fever etiology studies demonstrate brucellosis as a cause of
undifferentiated febrile illness in the developing world. Brucellosis is a rare cause
of fever among returning travelers, but is more common among travelers returning from
the Middle East and North Africa. Sensitive and specific rapid diagnostic tests appropriate
for resource-limited settings have been validated. Randomized controlled trials demonstrate
that optimal treatment for human brucellosis consists of doxycycline and an aminoglycoside.
Decreasing the burden of human brucellosis requires control of animal brucellosis,
but evidence to inform the design of control programs in the developing world is needed.
SUMMARY: Brucellosis causes substantial morbidity in human and animal populations.
While improvements in diagnostic options for resource-limited settings and stronger
evidence for optimal therapy should enhance identification and treatment of human
brucellosis, prevention of human disease through control in animals remains paramount.
Type
Journal articleSubject
AnimalsAsia
Brucellosis
Humans
Livestock
Middle East
Neglected Diseases
Socioeconomic Factors
Zoonoses
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https://hdl.handle.net/10161/13778Published Version (Please cite this version)
10.1097/QCO.0b013e3283638104Publication Info
Rubach, Matthew P; Halliday, Jo EB; Cleaveland, Sarah; & Crump, John A (2013). Brucellosis in low-income and middle-income countries. Curr Opin Infect Dis, 26(5). pp. 404-412. 10.1097/QCO.0b013e3283638104. Retrieved from https://hdl.handle.net/10161/13778.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
John Andrew Crump
Adjunct Professor in the Department of Medicine
I am based in northern Tanzania where I am Site Leader for Duke University’s
collaborative research program based at Kilimanjaro Christian Medical Centre and Director
of Tanzania Operations for the Duke Global Health Institute. I oversee the design
and implementation of research studies on infectious diseases, particularly febrile
illness, invasive bacterial disease, HIV-associated opportunistic infections, clinical
trials of antiretroviral therapy and prevention of mother-to-child tr
Matthew P. Rubach
Associate Professor of Medicine
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