Brucellosis among hospitalized febrile patients in northern Tanzania.

Abstract

Acute and convalescent serum samples were collected from febrile inpatients identified at two hospitals in Moshi, Tanzania. Confirmed brucellosis was defined as a positive blood culture or a ≥ 4-fold increase in microagglutination test titer, and probable brucellosis was defined as a single reciprocal titer ≥ 160. Among 870 participants enrolled in the study, 455 (52.3%) had paired sera available. Of these, 16 (3.5%) met criteria for confirmed brucellosis. Of 830 participants with ≥ 1 serum sample, 4 (0.5%) met criteria for probable brucellosis. Brucellosis was associated with increased median age (P = 0.024), leukopenia (odds ratio [OR] 7.8, P = 0.005), thrombocytopenia (OR 3.9, P = 0.018), and evidence of other zoonoses (OR 3.2, P = 0.026). Brucellosis was never diagnosed clinically, and although all participants with brucellosis received antibacterials or antimalarials in the hospital, no participant received standard brucellosis treatment. Brucellosis is an underdiagnosed and untreated cause of febrile disease among hospitalized adult and pediatric patients in northern Tanzania.

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Citation

Published Version (Please cite this version)

10.4269/ajtmh.2012.12-0327

Publication Info

Bouley, Andrew J, Holly M Biggs, Robyn A Stoddard, Anne B Morrissey, John A Bartlett, Isaac A Afwamba, Venance P Maro, Grace D Kinabo, et al. (2012). Brucellosis among hospitalized febrile patients in northern Tanzania. Am J Trop Med Hyg, 87(6). pp. 1105–1111. 10.4269/ajtmh.2012.12-0327 Retrieved from https://hdl.handle.net/10161/13793.

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Scholars@Duke

Bartlett

John Alexander Bartlett

Professor of Medicine

My clinical investigation is focused on the pathogenesis and treatment of HIV infection and its complications, especially in resource-limited settings.

Key Words: HIV infection, AIDS, treatment strategies, treatment failure, co-infections, resource-limited settings

Crump

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 transmission of HIV, and infectious diseases diagnostics. In addition, I am a medical epidemiologist with the US Centers for Disease Control and Prevention (CDC). My CDC work focuses on enteric infection epidemiology and prevention in developing countries, particularly invasive salmonelloses.


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