ArticleEpidemiology and health2022
Investigation of a human brucellosis outbreak in Douz, Tunisia, 2018.
Article in Epidemiology and health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Meta-analysis of brucellosis and relative risks.Medicine · 2026Pooled it
- [Human brucellosis: three faces of an insidious zoonosis].Medecine tropicale et sante internationale · 2026Article
- Article
- Field epidemiology training in Tunisia: achievements and gaps.Frontiers in public health · 2026Article
- Sero-prevalence of human brucellosis and associated factors among febrile patients attending Moyale Primary Hospital, Southern Ethiopia, 2023: Evidences from pastoralist community.PLoS neglected tropical diseases · 2024Article
- Long ignored but making a comeback: a worldwide epidemiological evolution of human brucellosis.Emerging microbes & infections · 2024Review
- Native circulatingFrontiers in microbiology · 2023Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIn 2017, the incidence of human brucellosis in Tunisia was 9.8 per 100,000 population. In the Douz district, 2 cases were reported in March 2018. Prior to that date, the last indigenous cases to be reported in Douz had been in 2015. This study aimed to identify the source of this new contamination and recommend control interventions.
methodsThis case-control study included residents of Douz who presented with clinical symptoms of brucellosis and had a subsequent Wright test antibody titer ≥ 1/160. The controls were neighbors of the infected cases who had a negative Rose Bengal test. Univariate and multivariate analyses were performed to estimate the odds ratios of risk factors. Goats belonging to the cases and controls were actively screened.
resultsTwenty-five infected cases and 52 uninfected controls were enrolled. All infected cases had consumed goat milk and 92% had purchased it from the same breeder. Consumption of goat milk from this breeder (adjusted odds ratio [aOR], 30.78; 95% confidence interval [CI], 6.47 to 235.91) and overall consumption of raw goat milk (aOR, 14.84; 95% CI, 2.04 to 310.44) were independent risk factors for brucellosis. The breeder had 18 goats, 5 of which were smuggled from a neighboring country. Three of those goats were diagnosed with brucellosis.
conclusionsConsumption of raw milk from smuggled sick goats was the main risk factor in this outbreak. The sick goats were slaughtered and an education campaign was conducted. Vaccination, control of cross-border animal movements, and control of goat milk sales must be strengthened to prevent the spread of brucellosis in southwestern Tunisia.
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