A HOSPITAL-BASED SURVEY ON HUMAN BRUCELLOSIS AND RISK FACTORS

(A CASE STUDY OF KANO METROPOLIS)

By

Author

Presented To

Department of Medicine

ABSTRACT
Brucellosis is a zoonosis of major public health significance that occurs worldwide in both man and animals. Human brucellosis is a severe debilitating disease that requires prolonged treatment, if untreated can result in permanent disability and loss of productivity. Human brucellosis presents a great variety of clinical manifestations making it difficult to diagnose clinically. In some endemic areas every case of human fever of unknown origin is assumed to be due to brucellosis. Therefore, the diagnosis must be confirmed by laboratory tests. A study was conducted in Kano State, North-western Nigeria to determine the sensitivity of clinical diagnosis of human brucellosis and determine its risk factors of among hospital patients presenting to some selected hospitals with febrile illness. 
Methods: We conducted a cross-sectional descriptive study from September to December 2011. One major hospital was selected from each of the five local government areas within Kano metropolis. Two hundred and fifty participants were enrolled in the study. Data was obtained using a standardized questionnaire and blood samples were collected, screened with Rose Bengal Plate Test (RBPT) and confirmed for anti-Brucella immunoglobulin G (IgG) and antiBrucella immunoglobulin M (IgM) using Enzyme-linked immunosorbent assay (ELISA). Results: There were 50 samples that tested positive to RBPT and were confirmed by ELISA. Of the 50 positive cases, 36 (64%) were positive by IgG where as 14(28%) were positive by IgM. Independent risk factors for human brucellosis were consumption of fresh milk (p 0.02) and kindirmo (p 0.00); keeping goats (p 0.00), assisting animal parturition (p 0.01), processing raw meat (p 0.03) and eating raw meat (p 0.00). Clinical signs that had strong association with human brucellosis were recurrent fever (p 0.04), cough/sneeze (p 0.02) and osteomyelitis (p 0.00). Conclusion: Significant risk factors for Human Brucellosis in Kano were consumption of fresh milk and kindirmo(local yoghurt), processing and consumption of raw meat, keeping goats and assisting animals’ parturition. The government should sensitize the populace on the risks and importance of this disease and physicians should raise the index for diagnosis of human brucellosis by including it in their differential diagnosis in patients that present with signs suggestive of it such as recurrent fever, cough/sneezing, joint pains, and osteomyelitis. 
Key words: Brucellosis, Risk factors, Hospital, Kano.

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