| Objective: This study aims to describe the epidemiological,clinical characteristics,treatment and prognosis of human brucellosis during 2014-2018 in Huludao,Liaoning Province;explore the infection source,route of transmission,risk factors of human brucellosis,and provide theoretical basis for formulating corresponding prevention and control measures.Methods : 1.The incidence data and epidemiological case questionnaires of human brucellosis during 2014 to 2018 were collected from the Municipal Center for Disease Control and Prevention(CDC)in Huludao.2.The continuous variables were described as mean±standard deviations(x ±S)and the categorical variables were described as number and proportion(%).We defined the ‘N’ and ‘n’ as the total number of patients recording the certain variable and the number of cases with positive result,and the proportion is n/N.3.The data in this study were analyzed using IBM SPSS Statistics 21.0.The Linear-by-Linear Association was used to analyze the differences of incidence;the One-way ANOVA(Analysis of Variance)was used to analyze the differences in continuous variables;Chi-square test was used for categorical variables.P-values less than or equal to 0.05 were considered as statistically significant.Results: 1.A total of 1887 human brucellosis cases were reported from 2014 to 2018 in Huludao,Liaoning Province.The number of reported patients was reduced from 711 in2014 to 187 in 2018,with the incidence rate decreased from 27.31/100,000 to7.15/100,000 during these years.2.A total of 1149 individual data were collected from the epidemiological case questionnaires.Among them,most human brucellosis cases were aged in 41-60 years old(59.7%);the number of patients in male was much more than that in female and the ratio of male to female was about 3:1;occupational distribution: the most reported occupation was farmers/herdsmen,taking up 62.8% of1149 cases;and Xingcheng(29.2%)has always been the most epidemic district.3.The most common clinical symptoms were fatigue(87.5%),hyperhidrosis(86.6%),fever(84.4%)and arthralgia/myalgia(84.3%).Patients aged more than 60 years old(90.2%)were more likely to had arthralgia/myalgia than the other age groups(57.1%,77.3% and 85.8%,respectively),and patients who had enlarged spleen in male(17.6%)were more than that in female(10.2%,P<0.05).There were more acute brucellosis cases,less sub-acute and chronic brucellosis cases in the ethnic minority(83.6%,5.5% and 11.0%,respectively)than that in the Han nationality(64.7%,22.2% and 13.0%,respectively,P<0.05).The proportion of patients treated with antibiotic therapy(97.9%)was larger than other types,and ‘Doxycycline plus rifampicin or streptomycin’ was the most common used drug combination.Of 768 cases followed up,98.7% responded ‘improved’and ‘recovery’,only 1.3% responded ‘not improved’.4.Sheep/goat(97.8%)was the main contacted animal and feeding/grazing(79.8%)was the most frequent way of contacting,only few patients took preventive measures such as wearing gloves(16.8%),masks(11.9%),protective suit(2.2%)or using disinfectant(2.1%)when they contacted with the animals,and there were 86.6% of patients still drinking from same well with livestock.Conclusion: The incidence of human brucellosis reduced gradually during 2014-2018,but is still high in Huludao,Liaoning Province,farmers and herdsmen are at high risk and Xingcheng is a high-risk area,this is mostly associated with that people have a close contact with domestic animals(especially sheep/goat)without taking self-protective measures;Thus,it is of great significance to carry out health education on how to prevent human brucellosis in Huludao.2.There are statistical differences about some clinical symptoms and diagnosis in different age groups,gender,nationality and districts,which reminds the clinicians to pay attention to these features when make clinical diagnosis.3.The antibiotic therapy is common used and effective,however,the related information,especially the integrality and accuracy of the notifiable epidemiological case questionnaire,needs to be improved in order to provide more actual and objective information for both the physicians and policy-makers,and the related staff need to pay more attention to the investigation and report of human brucellosis. |
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