Introduction
Brucellosis emerged as an endemic public health problem in some locations of Saudi Arabia particularly at Nimran village in Al-Taif region, where main income source of the population was a breeding and farming domestic animals including sheep, goat, cattle and camels bred by the inhabitants. Objectives:This case-control study was conducted to identify the possible risk factors associated with a recent Brucellosis outbreak in Nimran village, Al-Taif region.
Methodology
A total of 44 (35.2%) Brucellosis cases and 81 (64.8%) healthy controls were included in the study according to several pre-defined selection criteria. The investigative team interviewed selected cases and controls face to face using a structured questionnaire to collect information including demographic data, symptoms and signs of Brucellosis, possible risk factors and potential sources of infection. Blood samples were extracted from the patients belonging to age ≥ 5 years to confirm laboratory diagnosis. Obtained data were entered and analyzed using Epi Info software version 3.2. Odds ratios and 95% confidence intervals were calculated to investigate the presence of significant associations between the disease and risk factors.
Results
Out of 44 Brucellosis cases, majority (26, 59.1%) complained of fever, while 20 (45.5%) patients suffered from headache, followed by 16 (36.4%) from generalized body aches, 13 (29.5%) from profuse sweating, and 12 (27.3%) suffered from chills. Moreover, 11 (25%) cases developed joint pain without inflammation, 10 (22.7%) patients had recent history of weight loss, 4 (9.1%) suffered from joint pain with inflammation, and only 1 (2.3%) of them developed abscess. Study population used to consume food products from three types of animal herds such as camels 26/125 (20.8%), sheep or goats 79/125 (63.2%), and cows 1/125 (0.8%). Study findings revealed that Brucellosis was not significantly associated with the risk factors related to individual's consumption habit of animal milk such as daily drinking of camel milk (OR=0.78, 95% CI=0.28-2.15), daily consumption of sheep/goat milk (OR=1, 95% CI=0.24-4.47), drinking of non-pasteurized/non-boiled raw camel milk (OR=0.98, 95% CI=0.16-5.43), consumption of sheep/goat milk in raw form (OR=1.09, 95% CI=0.18-6.82). Similarly, study findings failed to show any statistical significant relationship among the disease and the risk factors related to individual's eating habit of animal products such as frequently eating of home made butter (OR=0.71, 95% CI=0.20-2.53), Mudeer from Laban (OR=1.58, 95% CI=0.39-6.84), semi-cooked meat (OR=0.77, 95% CI=0.15-3.58), raw liver (OR=3.81, 95% CI=0.26-109.52). Moreover, respondents who had experience of contact with camels (OR=1.06, 95% CI=0.37-3.04), with sheep/goats (OR=0.84, 95% CI=0.38-1.87), experience of animal delivery (OR=1.06, 95% CI=0.37-3.04), ownership of camel farms (OR=0.78, 95% CI=0.28-2.14), sheep/goat farms (OR=1.20, 95% CI=0.52 - 2.78), were not at significantly increased risk of developing Brucellosis.
Conclusion
The study findings could not establish any significant association between some probable risk factors and the outbreak of Brucellosis in the study location. It is suggested that veterinary services and health education programs should be increased to minimize exposure to infected farm animals and to reduce the risk of the disease not only in the current study area, but also in other Brucellosis endemic locations in Saudi Arabia.