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Brucellosis in wildlife in Africa: a systematic review and meta-analysis.

ABSTRACT: This study aimed to consolidate current knowledge of wildlife brucellosis in Africa and to analyse available predictors of infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Information on species, test used, test results, area, rainfall, livestock and wildlife contact and year of study were extracted. This systematic review revealed 42 prevalence studies, nine disease control articles and six articles on epidemiology. Brucella abortus, Brucella melitensis, Brucella inopinata and Brucella suis were reported in wildlife. The prevalence studies revealed serological evidence of brucellosis in buffalo, antelope (positive in 14/28 species), carnivores (4/12) and other species (7/20) over the last five decades. Buffalo populations were more likely to be infected and had a higher seroprevalence than other species; the pooled seroprevalence was 13.7% (95% CI 10.3-17.3%) in buffalo, 7.1% (95% CI 1.1-15.5%) in carnivores and 2.1% (95% CI 0.1-4.9%) in antelope. Wildlife in high rainfall areas (≥ 800 mm) were more likely to be infected, and infected populations showed higher seroprevalence in high rainfall areas and in studies published after 2000. Domestic animal contact was associated with increased seroprevalence in antelope and carnivore species, but not in buffalo, supporting the hypothesis that buffalo may be a reservoir species.

SUBMITTER: Simpson G

PROVIDER: S-EPMC7966391 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Brucellosis in wildlife in Africa: a systematic review and meta-analysis.

Simpson Gregory G Thompson Peter N PN Saegerman Claude C Marcotty Tanguy T Letesson Jean-Jacques JJ de Bolle Xavier X Godfroid Jacques J

Scientific reports 20210316 1

This study aimed to consolidate current knowledge of wildlife brucellosis in Africa and to analyse available predictors of infection. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Information on species, test used, test results, area, rainfall, livestock and wildlife contact and year of study were extracted. This systematic review revealed 42 prevalence studies, nine disease control articles and six articles on epidemiology. Brucella abortus, Br ...[more]

PMID: 33727580

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Project description:BackgroundBrucellosis, a widely spread zoonotic disease, poses significant diagnostic challenges due to its non-specific symptoms and underreporting. Timely and accurate diagnosis is crucial for effective patient management and public health control. However, a comprehensive comparative review of available diagnostic tests is lacking.Methodology/principal findingsThis systematic review addressed the following question: 'What is the accuracy of the available tests to confirm human brucellosis?' Two independent reviewers examined articles published up to January 2023. The review included original studies reporting symptomatic patients with brucellosis suspicion, through any index test, with sensitivity and/or specificity as outcomes. As exclusion criteria were considered: sample size smaller than 10 patients, studies focusing on complicated brucellosis, and those lacking essential information about index or comparator tests. Sensitivity and specificity were assessed, with consideration for the index test, and 'culture' and 'culture and standard tube agglutination test (SAT)' were used as reference standards. Bias assessment and certainty of evidence were carried out using the QUADAS-2 and GRADE tools, respectively. A total of 38 studies reporting diagnostic test performance for human brucellosis were included. However, the evidence available is limited, and significant variability was observed among studies. Regarding the reference test, culture and/or SAT are deemed more appropriate than culture alone. Rose Bengal, IgG/IgM ELISA, and PCR exhibited equally high performances, indicating superior overall diagnostic accuracy, with very low certainty of the evidence.Conclusions/significanceThis systematic review underscores the potential of the Rose Bengal test, IgG/IgM ELISA, and PCR as promising diagnostic tools for brucellosis. However, the successful implementation and recommendations for their use should consider the local context and available resources. The findings highlight the pressing need for standardization, improved reporting, and ongoing advancements in test development to enhance the accuracy and accessibility of brucellosis diagnosis.

Project description:BackgroundThe objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of specifying a disability weight for a DALY calculation.Methods/principal findingsThirty three databases were searched, with 2,385 articles published between January 1990-June 2010 identified as relating to human brucellosis. Fifty-seven studies were of sufficient quality for data extraction. Pooled proportions of cases with specific clinical manifestations were stratified by age category and sex and analysed using generalized linear mixed models. Data relating to duration of illness and risk factors were also extracted. Severe complications of brucellosis infection were not rare, with 1 case of endocarditis and 4 neurological cases per 100 patients. One in 10 men suffered from epididymo-orchitis. Debilitating conditions such as arthralgia, myalgia and back pain affected around half of the patients (65%, 47% and 45%, respectively). Given that 78% patients had fever, brucellosis poses a diagnostic challenge in malaria-endemic areas. Significant delays in appropriate diagnosis and treatment were the result of health service inadequacies and socioeconomic factors. Based on disability weights from the 2004 Global Burden of Disease Study, a disability weight of 0.150 is proposed as the first informed estimate for chronic, localised brucellosis and 0.190 for acute brucellosis.ConclusionsThis systematic review adds to the understanding of the global burden of brucellosis, one of the most common zoonoses worldwide. The severe, debilitating, and chronic impact of brucellosis is highlighted. Well designed epidemiological studies from regions lacking in data would allow a more complete understanding of the clinical manifestations of disease and exposure risks, and provide further evidence for policy-makers. As this is the first informed estimate of a disability weight for brucellosis, there is a need for further debate amongst brucellosis experts and a consensus to be reached.

Project description:ObjectivesTo determine and quantify differences in efficacy between treatment regimens for brucellosis.DesignSystematic review and meta-analysis of randomised controlled trials assessing different antibiotic regimens and durations of treatment for human brucellosis.Data sourcesPubMed, CENTRAL, Lilacs, conference proceedings, and bibliographies with no restrictions on language, study year, or publication status. Review methods Search, application of inclusion and exclusion criteria, data extraction, and assessment of methodological quality independently performed in duplicate. Primary outcomes were relapse and overall failure resulting from primary failure or relapse. Relative risks with 95% confidence intervals were calculated and pooled with a fixed effect model.Results30 trials and 77 treatment arms were included. Overall failure was significantly higher with doxycycline-rifampicin compared to doxycycline-streptomycin, mainly due to a higher rate of relapse (relative risk 2.80, 95% confidence interval 1.81 to 4.36; 13 trials, without heterogeneity). Results were consistent among patients with bacteraemia and complicated brucellosis. Doxycycline-streptomycin resulted in a significantly higher rate of failure than doxycycline-rifampicin-aminoglycoside (triple drug regimen) (2.50, 1.26 to 5.00; two trials). Gentamicin was not inferior to streptomycin (1.45, 0.52 to 4.00 for failure; two trials). Quinolones combined with rifampicin were significantly less effective than doxycycline combined with rifampicin or streptomycin (1.83, 1.11 to 3.02, for failure; five trials). Monotherapy was associated with a higher risk of failure than combined treatment when administered for a similar duration (2.56, 1.55 to 4.23; five trials). Treatment for six weeks or more offered an advantage over shorter treatment durations.ConclusionsThere are significant differences in effectiveness between currently recommended treatment regimens for brucellosis. The preferred treatment should be with dual or triple regimens including an aminoglycoside.

Project description:Brucellosis is an endemic disease in food-producing animals in Mosul, Iraq. The objectives of the study reported here were: (i) to identify and assess the evidence and knowledge gaps in published studies that have examined brucellosis in different food-producing animals in Mosul, Iraq; using systematic review approach, and (ii) to quantify the seroprevalence of brucellosis in the city using meta-analysis approach. Google Scholar was used as a search engine to track pertinent peer-reviewed research reports. The search was conducted on November 24, 2019. Keywords used were: brucella, animal, Mosul, Iraq. Peer-reviewed published studies, MSc theses, and PhD dissertations written in Arabic or English were included. Duplicate records were removed, and the screening process was conducted at three levels: titles, abstracts, and full-text articles. Identified studies that have reported the seroprevalence of brucellosis were included in a meta-analysis to calculate an overall prevalence. A total of 214 records were initially identified. Seventeen research reports were added from personal contact and qualified articles' references list. Thirty six articles were qualified for review after removing 35 duplicate records, 155 titles, 11 abstracts, and 5 full text articles. Seventeen studies reported the prevalence of brucellosis, 11 studies assessed different serological tests for diagnosis of brucellosis, 9 studies isolated Brucella spp. from animal specimens and/or animal products, and 4 studies assessed vaccination procedures against brucellosis. The overall seroprevalence of brucellosis in food-producing animals in Mosul over a period of 40 years was 14.14%, including 14.46% for sheep, 12.99% for goats, 11.69% for cattle, and 22.64% for buffalo. The study concluded that the disease is evident in the city with increasing trends over the years, buffalo shows high seroprevalence, the degree of agreement of Rose-Bengal test as a screening test is fair compared to more accurate serological tests such as ELISA; and the disease constitutes a public health concern in the city. Additional studies are important to identify the overlooked predisposing factors, estimate the abortion rate attributable to brucellosis in food-producing animals, and evaluate efficacy of vaccination programs in reducing the prevalence of brucellosis and/or abortion rate.

Dataset Information

Brucellosis in wildlife in Africa: a systematic review and meta-analysis.

Publications

Brucellosis in wildlife in Africa: a systematic review and meta-analysis.

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