Concurrent Brucellosis and Q Fever Infection: a Case Control Study in Bamyan Province, Afghanistan
Main Article Content
Abstract
Background: More than 500,000 people are affected by brucellosis each year while the incidence of Q fever is poorly recorded. Consistent outbreaks of brucellosis have been reported in Afghanistan, affecting social and economic life. This study aimed to determine the means of propagation of brucellosis and Q-fever and establish appropriate control measures for both.
Methods and Materials: An outbreak of 1,317 cases of brucellosis and Q fever was investigated from May 2011 to the end of 2012 in Bamyan province of Afghanistan.A total of 100 cases were selected by random sampling with equal number of neighbor controls. Data were collected through structured questionnaire.
Results: The average age was 30 years ±14 years. Of those sampled, 62% were female, 38% were male, and resided in three districts: Punjab, Yakawlang and Waras. Using multivariate analysis, being a housewife (OR=7.36), being within proximity of kitchens to barns (OR= 2.98), drinking un-boiled milk (OR= 5.26), butchering (OR= 3.53) and purchasing new animals in the last six months (OR= 3.53) were significantly associated with contraction of brucellosis and Q fever.
Conclusion: Health educators should focus on families dealing with animals, especially on females. Pasturing, healthy milking, dunging, and slaughtering practices, along with use of safe dairy products should be the focus of preventive measures.
Article Details
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.
References
Young EJ. An overview of human brucellosis.Clin Infect Dis. 1995; 21:283–90.
Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005; 352:2325–36.
American Public Health Association.Control of Communicable Disease Manual, 19ed.2008:88.
Sadrizadeh B. Communicable disease control programmes in the Eastern Mediterranean Region of the World Health Organization. Archives of Iranian medicine.1999; 2:28–37.
Corbell JM. Brucellosis: an overview. Emerg Infect Dis. 1997; 2:213-21.
World Health Organization. The Control of Neglected Zoonotic Diseases. In: Report of the first meeting on the control of neglected zoonotic diseases. Geneva, Switzerland; 2006.
Robinson A. Guidelines for coordinated human and animal brucellosis surveillance. FAO animal production and health paper 156. Rome: Emergency Prevention System, Food and Agriculture Organization of the United Nations; 2003.
Cooper CW. Risk factors in transmission of brucellosis from animals to humans in Saudi Arabia. Department of Community Medicine, University of Sydney, Croydon, NSW, Australia.
Al-Shamahy HA, Whitty CJ, Wright SG. Risk factors for human brucellosis in Yemen: a case control study. Faculty of Medicine & Health Sciences, University of Sana'a, Yemen.
Sofian M, Aghakhani A, Velayati AA, Banifazl M, Eslamifar A, Ramezani A. Risk factors for human brucellosis in Iran: a case-control study. Arak Medical University, Arak, Iran.
John K, Fitzpatrick J, French N, Kazwala R, Kambarage D, Mfinanga GS, MacMillan A, Cleaveland S. Quantifying risk factors for human brucellosis in rural northern Tanzania.PLoS One. 2010; 5(4):e9968.
Cetinkaya Z, Aktepe OC, Ciftci IH, Demirel R. Seroprevalence of human brucellosis in a rural area of Western Anatolia, Turkey.J Health PopulNutr. 2005 Jun;23(2):137-41.
Earhart K, Vafakolov S, Yarmohamedova N, Michael A, Tjaden J, Soliman A. Risk factors for brucellosis in Samarqand Oblast, Uzbekistan.Int J Infect Dis. 2009 Nov;13(6):749-53.
Turatbek B. Kozukeev, Ajeilat S, Maes E, Favorov M. Risk factors for brucellosis--Leylek and Kadamjay districts, Batken Oblast, Kyrgyzstan, January-November, 2003. MMWR Morb Mortal Wkly Rep. 2006 Apr 28;55 Suppl 1:31-4.
Marrie TJ, Raoult D. Coxiellaburnetii (Q fever). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:ch 189.
Centers for Disease Control and Prevention. Potential for Q fever infection among travelers returning from Iraq and the Netherlands. Available at http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00313. Accessed 12 May, 2010.
Wallace MR, Hale BR, Utz GC, Olson PE, Earhart KC, Thornton SA, Hyams KC. Endemic infectious diseases of Afghanistan. Clin Infect Dis. 2002 Jun 15;34(Suppl 5):S171-207.
Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis.a review paper in Lancet Infect Dis 2006; 6: 91–99
World Organisation for Animal Health. Handistatus II: zoonoses (human cases): global cases of brucellosis in 2004. http://www.oie.int. Accessed 13 Nov, 2011.
Outbreak Reports. Disease Early Earning System/Surveillance Department, Afghan Public Health Institute, Ministry of Public Health, Kabul, Afghanistan.
Statistics by Country for Q fever. Accessed atwww.wrongdiagnosis.com.
Glennie JS, Bailey MS. UK Role 4 military infectious diseases at Birmingham Heartlands Hospital in 2005-9.J R Army Med Corps. 2010 Sep;156(3):162-4.
Aronson NE, Sanders JW, Moran KA. In harm's way: infections in deployed American military forces.Clin Infect Dis. 2006 Oct 15;43(8):1045-51.
IBM SPSS Statistics for Windows [computer program]. Version 20.0. Armonk, NY: IBM Corporation; 2011
Minas M, Minas A, Gourgulianis K, Stournara A. Epidemiological and clinical aspects of human brucellosis in Central Greece. Jpn J Infect Dis. 2007 Nov;60(6):362-6.
Bikas C, Jelastopulu E, Leotsinidis M, Kondakis X.Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece. Eur J Epidemiol. 2003;18(3):267-74.