Seroprevalence and Risk Factors for Brucella Infections in Jordan

Serological prevalence of Brucella spp. at the livestock-human interface in Jordan

Despite its endemic status in the Middle East, key knowledge gaps persist regarding the prevalence, transmission rate, and geographical distribution of both human and livestock brucellosis in Jordan. This study aimed to investigate the seroprevalence of human and livestock brucellosis as well as the incidence of brucellosis in humans in Jordan. A total of 500 human participants (202 exposed and 296 unexposed to livestock) were enrolled in the study. Sampling was conducted at baseline and 1.5 years later. Additionally, a total of 700 livestock were sampled, comprising 20 animals per taxa (camels, cattle, sheep, goats) per site, at both baseline (N = 350) and the 1.5-year follow-up (N = 350). Human participants were longitudinally followed, whereas livestock sampling was conducted opportunistically. Blood samples obtained from both humans and livestock at baseline and follow-up were tested for Brucella spp. serum antibodies using the Rose Bengal test (RBT) and complement fixation test (CFT). The overall seroprevalence of brucellosis in humans at baseline was 3.4 % (95 % CI: 2.0-5.4). Positive test results in humans were detected from all five sites with no significant regional variation observed. Seroprevalence was higher in individuals regularly exposed to livestock (6.1 %; 95 % CI: 3.5-9.9) compared to those not regularly exposed (0.80 %; 95 % CI: 0.10-2.9). Incidence of human brucellosis was 924 seropositives per 100,000 person-years, with all incident seropositives occurring in the livestock-exposed cohort. In livestock, the overall seroprevalence of brucellosis was 5.4 % (95 % CI: 3.5-8.3) at baseline compared to 2.6 % (95 % CI: 1.4-4.8) at follow-up. Seropositive livestock were detected at all sites apart from Al-Zarqa, and in all species apart from camels. In conclusion: Brucellosis burden was higher among humans regularly exposed to livestock, re-emphasizing the need for disease control in livestock populations to prevent primary infection in humans.

Exploring the Complex Landscape of Spine Brucellosis

INTRODUCTION

Brucellosis is an infectious illness contracted by humans through the consumption of unpasteurized milk and dairy items. Brucella organisms are diminutive, gram-negative, non-motile, and non-spore-forming facultative intracellular, aerobic intracellular coccobacilli residing within the reproductive organs of host animals, leading to conditions such as abortions and sterility. Numerous species of Brucella have been identified, with the following four exhibiting varying degrees of pathogenicity in humans: Brucella melitensis (originating from sheep), Brucella suis (associated with pigs), Brucella abortus (linked to cattle), and Brucella canis (found in dogs). B. melitensis and B. suis demonstrate the highest level of pathogenicity, while B. abortus and B. canis exhibit a more moderate degree of pathogenicity. The illness can progress to systemic involvement, with the musculoskeletal system being particularly susceptible to complications. Spinal epidural abscess is an infrequent complication that may occur during spondylitis caused by Brucella species. Epidural abscesses most commonly affect the lumbar vertebrae, while their involvement in the cervical spine is relatively rare.

OBJECTIVE

In this review, we explore spine brucellosis, covering its epidemiology, pathogenesis, clinical manifestations, diagnostics, and evolving treatments. We aim to enhance early detection, timely intervention, and patient outcomes.

PATIENTS AND METHODS

This retrospective chart analysis was conducted by revising all medical files for patients in whom spinal brucellosis was diagnosed and managed.

RESULTS

This study was conducted at King Hussein Medical Center (KHMC), Jordan, and included a total of 20 patients who were diagnosed with spine brucellosis during the study period. Within the final cohort, 65% of the patients were male (13/20), with an average age at diagnosis of 47.53±14.98 years (ranging from 4 to 61 years). The female group, on the other hand, had an average age at diagnosis of 51.12±15.55 years (ranging from 3 to 58 years). Statistical analysis of the data revealed no significant demographic differences between the two groups. Regarding the co-morbidities, no statistical differences were observed between the two groups. Examining the occupational status of the two groups, no differences were observed. Also, no differences were observed between the two groups regarding the residence place, or the spinal segment involved.

CONCLUSION

Spine brucellosis, although uncommon, poses a complex clinical challenge. Early diagnosis and a multidisciplinary approach are crucial for effective management. Further research is needed to refine diagnostic tools and treatment guidelines for spine brucellosis.