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Brucellosis in low-income and middle-income countries.

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Date
2013-10
Authors
Rubach, Matthew P
Halliday, Jo EB
Cleaveland, Sarah
Crump, John A
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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 article
Subject
Animals
Asia
Brucellosis
Humans
Livestock
Middle East
Neglected Diseases
Socioeconomic Factors
Zoonoses
Permalink
https://hdl.handle.net/10161/13778
Published Version (Please cite this version)
10.1097/QCO.0b013e3283638104
Publication 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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Scholars@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
Rubach

Matthew P. Rubach

Associate Professor of Medicine
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