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Brucellosis in a City Setting




In 1988, the Al-Jouf Region reported 503 brucellosis cases per 100,000 population, the highest rate among all regions of Saudi Arabia. Many cases were from Sakaka city (incidence rate = 226/100,000 per year), the capital. In November 1989 we reviewed surveillance records for brucellosis in Al-Jouf and initiated intensive case finding through Sakaka Central Hospital Laboratory. We defined brucellosis cases as physician-diagnosed brucellosis supported by a brucella agglutination titer of ≥ 1:160. We compared cases from Sakaka City with control persons, matched by sex, age (± 5 yr) and neighborhood, for exposure to dairy products, meat and livestock. Laboratory and surveillance records for 1988 yielded a higher incidence rate (1441/100,000) than previously reported. Cases were mostly in adults with no difference between sexes. Comparison of 64 cases with 170 controls collected from January to March 1990 showed no relation between any dairy products and brucellosis. There were strong associations between brucellosis and keeping livestock at home (OR 6.0, 95% CI 3.0-12.1), milking livestock (OR 21.9, 95% CI 9.4- 52.1) and having an open wound or cutting one's hand while cutting meat (OR 3.8, 95% CI 1.9-7.9). Human brucellosis in Sakaka City, Al-Jouf Region, Saudi Arabia, is largely due to close contact with farm animals kept in or near houses within the city limits. Conclusion: