New area of occurrence of human brucellosis in Brazil: serological and molecular prevalence and risk factors associated with Brucella abortus infection.

IF 3.8 Q2 INFECTIOUS DISEASES
Thaís de Souza de Matos, Ana Leticia Pereira Fernandes, Ividy Bison, Andréa Silva de Medeiros Bandeira, Wigínio Gabriel de Lira Bandeira, Jordan de Castro Nunes, Eduardo Sérgio Soares Souza, Vinícius Pietta Perez, Vinicius Longo Ribeiro Vilela, Roberta Nunes Parentoni, Arthur Willian de Lima Brasil
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Abstract

Background: Brucellosis is a re-emerging underdiagnosed zoonosis that has significant relevance, especially in developing countries. This study aimed to report the first cases of human brucellosis in the state of Paraíba, Brazil, and to determine the prevalence and risk factors associated with Brucella abortus infection in slaughterhouse workers.

Methods: A cross-sectional study was carried out from December 2021 to February 2022 in public and private slaughterhouses in the state of Paraíba. Blood samples were collected from 188 people and tested using the Rose Bengal Test (RBT), a screening test, and the 2-mercaptoethanol (2-ME) and standard tube agglutination test (STAT), which are confirmatory tests. Samples that tested positive were subjected to molecular analysis using qPCR. Risk factors were determined through multivariate analysis based on epidemiological questionnaires administered to the workers. After the diagnoses, results were provided to the participants, and health education campaigns were conducted for all workers in the evaluated slaughterhouses.

Results: The study found a serological prevalence (RBT + 2-ME + STAT) of 4.2% (16/188) (95% CI = [1.28; 6.96], sensibility 90% specificity 95%)among workers. Five samples were positive in qPCR with Ct (Cycle threshold ) values ranging from 31.58 to 38.11. The ingestion of undercooked meat was identified as a risk factor, with a 2.95 times higher chance of contamination. Among the 16 individuals who tested positive in the serological tests, 15 (p<0.0001) reported in the epidemiological questionnaire that they did not know what brucellosis is.

Conclusion: These are the first published cases of human brucellosis in the state of Paraíba, reinforcing the hypothesis that the bacterium is circulating among slaughterhouse workers. This underscores the need to develop public policies that provide adequate medical support to the population.

背景:布鲁氏菌病是一种重新出现的诊断不足的人畜共患疾病,尤其在发展中国家具有重要意义。本研究旨在报告巴西帕拉伊巴州的首例人类布鲁氏菌病病例,并确定屠宰场工人感染流产布鲁氏菌的流行率和相关风险因素:2021 年 12 月至 2022 年 2 月,在帕拉伊巴州的公共和私营屠宰场开展了一项横断面研究。研究人员采集了 188 人的血样,并使用玫瑰孟加拉试验(RBT)(筛查试验)、2-巯基乙醇试验(2-ME)和标准管凝集试验(STAT)(确证试验)进行检测。对检测呈阳性的样本采用 qPCR 进行分子分析。根据向工人发放的流行病学调查问卷,通过多变量分析确定风险因素。诊断后,向参与者提供了结果,并对接受评估的屠宰场的所有工人开展了健康教育活动:研究发现,工人的血清学流行率(RBT + 2-ME + STAT)为 4.2% (16/188) (95% CI = [1.28; 6.96],敏感性 90% 特异性 95%)。有五个样本在 qPCR 中呈阳性,Ct(周期阈值)值在 31.58 至 38.11 之间。摄入未煮熟的肉类被认为是一个风险因素,受污染的几率要高出 2.95 倍。在血清学检测呈阳性的 16 人中,有 15 人(pConclusion:这是帕拉伊巴州首次公布人类布鲁氏菌病病例,进一步证实了布鲁氏菌在屠宰场工人中流行的假设。这突出表明,有必要制定公共政策,为民众提供充分的医疗支持。
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