Human brucellosis: sero-prevalence and associated risk factors in agro-pastoral communities of Kiboga District, Central Uganda

Abstract

Abstract

Background: Brucellosis remains a neglected zoonotic disease among agro-pastoral communities where
unprocessed milk and milk products are consumed. A cross-sectional study was carried out in Kiboga district to
determine the seroprevalence and risk factors associated with human brucellosis in communities where livestock
rearing in a common practice.
Methods: A total of 235 participants were involved in the study. Blood samples from the participants were
collected and screened for Brucella using Serum Agglutination Test and Rose Bengal Plate Test. A questionnaire was
used to collect data on socio-demographic characteristics and human brucellosis related risk factors.
Results: Human Brucella seroprevalence was at 17.0 % (n = 235). The prevalence was highest among males (20.5 %,
n = 78) and the elderly – above 60 years (22.2 %, n = 18). Residence in rural areas (OR 3.16, 95 % CI: 1.16–8.56),
consuming locally processed milk products (OR 2.54, 95 % CI: 1.12–5.78) and being single (OR 2.44, 95 % CI: 1.05–5.68), were associated with increased risk of brucellosis.
Discussion: Human brucellosis seroprevalence was high at 17 %, this was parallel with animal brucellosis prevalence
that has been reported to range from 10.2 % to 25.7 % in cattle in the region. The participants were from communities
known to habitually consume raw milk and milk products, know to process milk products using bare hands which are
major risk factors for brucellosis in humans. This also explains why consumption of unpasteurized milk products was
associated with the occurrence of brucellosis in study area. This strengthened the argument that humans get infected
through consumption of contaminated animal products as reported in other earlier studies. Males and elderly being
more affected because of traditional roles of these groups they play in livestock care and management. The single
were also to be more associated to brucellosis, due to the fact that this group consume milk and milk products more
as it is readily available in the informal markets as highly nutritious fast foods in this community as also observed in USA.
Conclusions: Brucellosis is highly prevalent in Kiboga district, and therefore, an important public health problem. The transmission risk was aggravated by consumption of unpasteurized milk products, residing in rural settings and being single. There is a need to initiate screening, treat infected humans early, and educate the public about risk factors and appropriate preventive measures of brucellosis.