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Clinical features of 2041 human brucellosis cases in China

Clinical features of 2041 human brucellosis cases in China
Clinical features of 2041 human brucellosis cases in China

BACKGROUND: Human brucellosis has become a major public health problem in China. However, the available clinical data on brucellosis cases are limited.

METHODS: We retrospectively reviewed medical charts of 2041 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. These patients were admitted to the Sixth People's Hospital of the Xinjiang Uygur Autonomous region between 1st January and 31st December 2014. Data on these patients were collected from hospital medical records.

RESULTS: Many patients presented with fatigue (67%), fever (64%), arthralgia (63%) and sweating (54%). High erythrocyte sedimentation rate (ESR) (69%), high C-reactive protein (CRP) (39%), high alanine aminotransferase (ALT) (33%) and high aspartate aminotransferase (AST) (20%) were the most common laboratory findings, especially in acute patients. There was evidence of focal involvement in 90% of patients. A total of 61.5% of brucellosis patients recovered. Multivariate logistic regression analyses suggested that the risk factors key to unfavorable prognosis were: age≥45 years (OR = 1.75, 95% CI 1.36-2.24), back pain (OR = 1.50, 95% CI 1.16-1.94) and joint tenderness (OR = 1.73, 95% CI 1.13-2.65). The increasing duration of the illness increased the risk of poor prognosis.

CONCLUSION: Patients with brucellosis showed different characteristics in different clinical stages. In China, the chronicity rate of human brucellosis is high. The risk of poor prognosis is increased in patients aged 45 years or older, patients who have had brucellosis for a substantial period of time, and patients with back pain or joint tenderness. The clinical management of brucellosis should be improved to include sensitive diagnostic methods for subacute and chronic brucellosis.

Journal Article
1932-6203
Shi, Yujing
cb8b0776-537b-4839-9015-1b7d86eadc12
Gao, Hui
d1b095e6-df29-4eb6-b7fb-efa6baf8e162
Pappas, Georgios
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Chen, Qiulan
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Li, Mei
482f90e4-e07a-45e9-ab99-3044993ed645
Xu, Jun
d40f5936-bae9-4923-ad02-31243d7ed559
Lai, Shengjie
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Liao, Qiaohong
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Yang, Wenwen
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Yi, Zhongtao
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Rouzi, Zulaguli
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Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c
Shi, Yujing
cb8b0776-537b-4839-9015-1b7d86eadc12
Gao, Hui
d1b095e6-df29-4eb6-b7fb-efa6baf8e162
Pappas, Georgios
789d532b-43e6-451e-b3c4-018f2e54d9bc
Chen, Qiulan
ba6f6420-7bdd-4650-b34d-b5e084baff96
Li, Mei
482f90e4-e07a-45e9-ab99-3044993ed645
Xu, Jun
d40f5936-bae9-4923-ad02-31243d7ed559
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Liao, Qiaohong
8fa88aa8-8b17-47a4-92b4-7f231beb7b8b
Yang, Wenwen
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Yi, Zhongtao
5ace2bc8-9342-4dfd-93a5-19b09eb4c243
Rouzi, Zulaguli
41e622ee-fbc7-4d14-be4a-51e74d6a8109
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c

Shi, Yujing, Gao, Hui, Pappas, Georgios, Chen, Qiulan, Li, Mei, Xu, Jun, Lai, Shengjie, Liao, Qiaohong, Yang, Wenwen, Yi, Zhongtao, Rouzi, Zulaguli and Yu, Hongjie (2018) Clinical features of 2041 human brucellosis cases in China. PLoS ONE, 13 (11). (doi:10.1371/journal.pone.0205500).

Record type: Article

Abstract

BACKGROUND: Human brucellosis has become a major public health problem in China. However, the available clinical data on brucellosis cases are limited.

METHODS: We retrospectively reviewed medical charts of 2041 patients with confirmed human brucellosis and prospectively recorded their outcomes by telephone interview. These patients were admitted to the Sixth People's Hospital of the Xinjiang Uygur Autonomous region between 1st January and 31st December 2014. Data on these patients were collected from hospital medical records.

RESULTS: Many patients presented with fatigue (67%), fever (64%), arthralgia (63%) and sweating (54%). High erythrocyte sedimentation rate (ESR) (69%), high C-reactive protein (CRP) (39%), high alanine aminotransferase (ALT) (33%) and high aspartate aminotransferase (AST) (20%) were the most common laboratory findings, especially in acute patients. There was evidence of focal involvement in 90% of patients. A total of 61.5% of brucellosis patients recovered. Multivariate logistic regression analyses suggested that the risk factors key to unfavorable prognosis were: age≥45 years (OR = 1.75, 95% CI 1.36-2.24), back pain (OR = 1.50, 95% CI 1.16-1.94) and joint tenderness (OR = 1.73, 95% CI 1.13-2.65). The increasing duration of the illness increased the risk of poor prognosis.

CONCLUSION: Patients with brucellosis showed different characteristics in different clinical stages. In China, the chronicity rate of human brucellosis is high. The risk of poor prognosis is increased in patients aged 45 years or older, patients who have had brucellosis for a substantial period of time, and patients with back pain or joint tenderness. The clinical management of brucellosis should be improved to include sensitive diagnostic methods for subacute and chronic brucellosis.

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Submitted date: 12 March 2018
Accepted/In Press date: 26 September 2018
e-pub ahead of print date: 26 November 2018
Published date: 26 November 2018
Keywords: Journal Article

Identifiers

Local EPrints ID: 426756
URI: https://eprints.soton.ac.uk/id/eprint/426756
ISSN: 1932-6203
PURE UUID: 6f4bfd04-0758-4883-ac8c-04192138f89f
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 11 Dec 2018 17:31
Last modified: 10 Dec 2019 01:23

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Contributors

Author: Yujing Shi
Author: Hui Gao
Author: Georgios Pappas
Author: Qiulan Chen
Author: Mei Li
Author: Jun Xu
Author: Shengjie Lai ORCID iD
Author: Qiaohong Liao
Author: Wenwen Yang
Author: Zhongtao Yi
Author: Zulaguli Rouzi
Author: Hongjie Yu

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