UNASSIGNED: Spinal involvement is a common but serious complication of human brucellosis. However, information on the risk factors associated with spinal involvement in individuals with brucellosis is limited.
UNASSIGNED: This retrospective case-control study aimed to determine the potential risk factors associated with spinal complications in inpatients with brucellosis.
UNASSIGNED: During the study period, brucellosis was diagnosed in 377 patients, of whom 108 (28.64%) showed spinal involvement. Those with spinal involvement were significantly older than patients in the control group (mean age [standard deviation], 53.25 [10.48] vs 43.12 [13.84] years, respectively; P < .001). The diagnostic delays were significantly longer in patients with spinal involvement than in the control group (mean delay [standard deviation], 11.17 [13.55] vs 6.03 [8.02] weeks; P = .001). Age >40 years (odds ratio, 5.42 [95% confidence interval, 2.65-11.05]; P < .001) and diagnostic delay >4 weeks (2.94 [1.62-5.35]; P < .001) were independently associated with spinal involvement in brucellosis. The lumbar spine at the L3-5 level was the most affected (152 of 249 [61.04%]). Back pain (92 of 108 in case patients vs 21 of 108 in controls; P < .001) and splenomegaly (23 vs 42 of 108, respectively; P = .005) differed significantly between the 2 groups.
UNASSIGNED: Age >40 years and diagnostic delay >4 weeks increased the risk of spinal involvement in brucellosis. Therefore, the time from symptom onset to diagnosis should be shortened, using effective measures to reduce spinal involvement risk.

UNASSIGNED: Epidemiological characteristics of human brucellosis (HB) have changed over the last decade. In this study, we depicted the spatiotemporal features of HB in Shenyang, China, from 2013 to 2022 and the objective was to visualise spatiotemporal patterns and identify high-risk regions with the purpose to provide evidence for HB prevention and control.
UNASSIGNED: We performed an observational epidemiological study using HB data obtained from the National Notifiable Disease Reporting System (NNDRS). Joinpoint regression analysis was employed to determine the changing trends in the annual incidence. A vector boundary map of Shenyang was used to visualise spatial distribution. Spatial autocorrelation was identified using both global and local Moran\'s autocorrelation coefficients, while hotspot areas were determined using the Getis-Ord statistic.
UNASSIGNED: A combined sum of 4103 HB cases were analysed, and the average level of annual incidence of HB was 5.52 per 100,000. The incidence of HB showed obvious seasonality, with a notable peak observed from April to July (summer peak). The annual incidence in Shenyang has been on the rise since 2013, with an annual percentage change (APC) of 6.39% (95%CI 1.29%, 12.39%). Xinmin County exhibited the most elevated average annual incidence rate, with Faku County ranking second. The average annual incidence in rural areas exhibited a significantly greater disparity compared to suburban areas (P < 0.001), whereas the incidence rate in suburban areas demonstrated a significantly higher contrast when compared to urban areas (P < 0.001). A clustered distribution of the annual incidence of HB was observed for all years from 2013 to 2022. Abnormally high values were found in suburban areas, and no abnormally high values were found after 2017. The low-low clustering areas were found in urban as well as suburban areas from 2013 to 2022. Hotspots (P < 0.05) were located in rural areas, while cold spots (P < 0.05) were found in both urban and suburban areas. Since 2020, there have been no hotspots in Shenyang.
UNASSIGNED: Rural areas are high-risk areas for HB and may be key to controlling HB epidemics. Although the annual incidence of HB in rural areas has increased, owing to the stability of spatial relationships and the disappearance of hotspots, there is little possibility of outbreaks; however, stricter monitoring should be applied in rural areas to prevent the emergence of new transmission routes.

With the booming of worldwide agriculture intensification, brucellosis, one of the most neglected zoonotic diseases, has become an increasing challenge for global public health. Although the transmission patterns of human brucellosis (HB) have been studied in many regions, the dynamic transfer processes of risk and its driving factors remain poorly understood, especially in the context of agricultural intensification. This study attempted to explore the risk transfer of HB between the exact epidemic areas and the neighboring or distant low-risk areas to explain the impact of livestock agriculture intensification and foodborne infections on the transmission of HB in Shaanxi Province as a case study. We adopted multiple approaches, including test-based methods, model-based methods, and a geographical detector to detect the spatial-temporal dynamic changes of high-risk epidemic areas of HB at the county scale. We also quantitatively estimated how the related factors drove the risk transfer of the disease. Results confirmed the risk transfer pattern of HB with an expansion from north to south in Shaanxi Province and identified two primary transfer routes. In particular, in the traditional epidemic areas of the Shaanbei plateau, the farm agglomeration effect can significantly increase the risk of HB. Meanwhile, retail outlets for milk and dairy products were partially responsible for the foodborne infections of HB in the emerging epidemic areas of Xi\'an. This study not only contributed helpful insights to support HB control and prevention in the rapid transition of livestock agriculture but also provided possible directions for further research on foodborne HB infections in urbanized areas.

Brucellosis is a very common zoonosis in certain localized areas worldwide, with a high prevalence in most developing countries. The detection of brucellosis still faces many challenges such as the need for more sensitive and specific diagnostic antigens.
To evaluate the efficacy of Brucella outer membrane proteins (Omps) Omp2b in combination with omp31 and BP26 as diagnostic antigens for the serological detection of human brucellosis, these proteins were prepared by a prokaryotic expression system. Human brucellosis-positive and-negative sera were collected, and the detection effects of the diagnostic antigens were evaluated using an established indirect ELISA (iELISA) method. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC), true positives, true negatives, false positives, false negatives, accuracy, positive predictive value, negative predictive value, analytical specificity, and sensitivity were obtained to evaluate the effectiveness of Omp2b and antigen combinations.
The iELISA results showed that the AUC of the antigenic proteins was 0.9100, 0.9387, 0.9343, and 0.9448, respectively, and that the combination of Omp31 and BP26 improved the accuracy and was superior to that of Omp2b alone. Analysis at the determined cut-off values showed that the analytical sensitivity of the assay was 0.8739 (95% CI:0.7974-0.9293) and the analytical specificity was 0.8539 (95% CI:0.7632-0.9199) when using Omp2b alone and 0.8649 when using the combination of Omp2b + BP26 (95% CI:0.7869-0.9223) with an analytical specificity of 0.9213 (95% CI:0.8446-0.9678) and 0.8468 (95% CI:0.7662-0.9082) and an analytical sensitivity of 0.9101 (95% CI:0.8305-0.9604). When Omp2b + Omp31 + BP26 was combined, the analytical sensitivity and specificity were 0.8559 (95% CI:0.7765-0.9153) and 0.9326 (95% CI:0.8590-0.9749), respectively. Protein antigens, including antigen combinations, did not cross-react with Yersinia enterocolitica O9 and E. coli O157: H7, indicating that their specificity was better than that of lipopolysaccharide (LPS).
Compared with individual Omp2b, antigen combinations improved the effectiveness in detecting brucellosis, but were still not as effective as LPS antigen. Omp2b, combined with Omp31 and BP26 as diagnostic antigens, can be used to detect human brucellosis.

BACKGROUND: Human brucellosis is a serious public health concern in China. The objective of this study is to develop a suitable model for forecasting human brucellosis cases in mainland China.
METHODS: Data on monthly human brucellosis cases from January 2012 to December 2021 in 31 provinces and municipalities in mainland China were obtained from the National Health Commission of the People\'s Republic of China website. The TBATS and ELM models were constructed. The MAE, MSE, MAPE, and RMSE were calculated to evaluate the prediction performance of the two models.
RESULTS: The optimal TBATS model was TBATS (1, {0,0}, -, {< 12,4 >}) and the lowest AIC value was 1854.703. In the optimal TBATS model, {0,0} represents the ARIMA (0,0) model, {< 12,4 >} are the parameters of the seasonal periods and the corresponding number of Fourier terms, respectively, and the parameters of the Box-Cox transformation ω are 1. The optimal ELM model hidden layer number was 33 and the R-squared value was 0.89. The ELM model provided lower values of MAE, MSE, MAPE, and RMSE for both the fitting and forecasting performance.
CONCLUSIONS: The results suggest that the forecasting performance of ELM model outperforms the TBATS model in predicting human brucellosis between January 2012 and December 2021 in mainland China. Forecasts of the ELM model can help provide early warnings and more effective prevention and control measures for human brucellosis in mainland China.

UNASSIGNED: Brucellosis is a neglected zoonotic disease of major public health concern. In India, the incidence of brucellosis remains vastly underreported due to its non-specific clinical presentation and sub-optimal sensitivity of existing gold standard tests. Studies in Northeast India have shown high incidences of brucellosis in livestock, but the region lacks data on human brucellosis despite its high associated risk. In the present study, we report the seroprevalence of human brucellosis and its associated risk factors in Meghalaya, Northeast India.
UNASSIGNED: A prospective observational study was conducted in East Khasi Hills and Ri.Bhoi districts of Meghalaya, from July 2018 to July 2020. A total of 1046 suspected patients with febrile illness along with associated risk factors were recruited through camps and various diagnostic laboratories in the defined region as per the pre.specified inclusion and exclusion criteria. Baseline, demographics, and clinical characteristics were recorded of all the consenting participants. Blood samples were analyzed for brucellosis-specific IgM antibodies through enzyme-linked immunosorbent assay (ELISA).
UNASSIGNED: The overall seroprevalence of brucellosis was found to be 11.37% in Meghalaya. Among recruited participants, females were found to be more susceptible than males. Risk factors such as consumption of meat were found to be more significantly associated with brucellosis disease in the study region. Among the clinical presentations, pyrexia of unknown origin, myalgia, and chronic fatigue syndrome were found to be significantly associated with brucellosis disease in IgM.positive cases.
UNASSIGNED: Our result suggests further epidemiological investigations for human brucellosis in Northeast India toward improved advocacy for accurate diagnosis, and development of proper response mechanism in areas of high endemicity.

BACKGROUND: Brucellosis is a disease of domestic and wild animals commonly caused by Brucella species and can be transmitted to humans (zoonosis). Susceptibility to Brucellosis in Humans depends on immune status, routes of infection, size of the inoculums, and to some extent, the species of Brucella. Globally more than 500,000 new cases are reported each year. In sub-Saharan Africa, Brucellosis prevalence is unclear and poorly understood with varying reports from country to country, geographical regions as well as animal factors.
METHODS: Facility-based unmatched case-control study was conducted on 167 patients with human brucellosis and 332 controls from February 27/2019 to May 20/2019 in AYU primary hospital, North Showa Zone, Ethiopia. descriptive statistics such as frequency and percentages were used to describe the profile of case and control and analytical statistics such as bivariate and multivariate logistic regression analysis was performed to identify the determinants of human brucellosis.
RESULTS: A total of 499 participants were included with a response rate of 99.60%. The mean age of participants was 45.46 years with a standard deviation (SD) of ±12.96 years. Human brucellosis had a statistically significant association with raw milk consumptions (AOR 5.75[95%CI 1.97-16.76]), slaughtering of animals at home(AOR 14.81[95%CI 3.63-60.38]), having contact with animal manure(AOR 2.87 [CI 1.08-7.62]), having contact with aborted cattle\'s fetus (AOR 3.01[95%CI 1.34-9.13]) and knowledge about brucellosis(AOR 0.29 [95%CI 0.08-0.83].
CONCLUSIONS: Generally in this study knowledge about Human Brucellosis, contact with animal manures, practicing animal slaughtering at home, having contact with animal ruminants, and consuming raw milk were identified as determinants for human brucellosis infection.

To describe the epidemiology of human brucellosis in the past decade and provide evidence of disease control in Tongliao city, which is one of the highest-risk areas of human brucellosis in Inner Mongolia province, China.
Cross-sectional study.
Clinically and bacteriologically confirmed human brucellosis cases.
An analysis of the reported cases of human brucellosis during 2007-2017 was carried out to describe the age, sex and occupational distributions of the cases. The time series analysis model and the geographical information system were explored to describe the seasonality and spatiotemporal distribution, respectively, at the county level.
A total of 13 938 cases of human brucellosis was collected in Tongliao from 2007 to 2017; the majority was aged 25 years to 59 years (85.4%) and the male-to-female ratio was 2.64:1; most of them were agriculturalists (81.9%) and pastoralists (12.4%). The incidence rates increased dramatically from 9.22/100 000 in 2007 to 69.16/100 000 in 2011 with an annual increase of 14.99%. They decreased during 2012-2016 (annual decrease of 8.37%) and rose again in 2017 (44.32/100 000). The disease peaked during March-July, with a clear periodicity and trend of monthly anterior displacement since 2012. Jarud Banner, the region located in the north-west of Tongliao, had the highest accumulated incidence rate (130.1/100 000) compared with other counties. The high-risk regions were spread from the north-west to the south and east of Tongliao during the past decade.
The prevalence of human brucellosis in Tongliao was aggravated during the past decade and peaked during March-July. High-risk areas were mainly concentrated in the counties with extensive prairies and livestock.

A cross-sectional study was conducted to determine the presence of brucellosis in cattle, goats and humans in farms from south-western Uganda and identify risk factors associated with brucellosis in these three host groups. Data and serum samples were collected from 768 cattle, 315 goats and 236 humans, with 635 samples of bovine milk, from 70 farms in two different study areas in south-western Uganda. Sera from livestock were tested with the Rose Bengal Plate test, using B. abortus and B. melitensis antigens, and human sera were tested with a commercial IgG/IgM lateral flow assay. Milk samples were tested using the OIE-approved milk ring test. Screening tests for brucellosis were positive in 14% of cattle serum, 29% of bovine milk, 17% of goat serum and 11% of human serum samples. There were significant differences in the test prevalence of brucellosis by study site, with levels higher in the study area near Lake Mburo National Park than in the study area near Queen Elizabeth National Park. Multivariable regression models identified risk factors associated with increasing test positivity at the individual and farm levels for cattle, goats and humans. Positive associations were seen between increasing seropositivity of brucellosis in goats, cattle and humans. Results of multivariable analyses suggest that improvements in farm biosecurity and hygiene may reduce the risk of brucellosis on the farm and suggest a role for ticks in bovine brucellosis. Although cattle are the focus of brucellosis control in Uganda, the significant associations between seropositivity in humans and seropositivity in goats suggest that brucellosis in goats may be an important contributor to the epidemiology of the disease on the farm.