Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China
Abstract Background Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biom...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | Infectious Diseases of Poverty |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40249-024-01186-4 |
| _version_ | 1827325729822474240 |
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| author | Qing-Nan Shi Hui-Jie Qin Qiao-Shan Lu Shu Li Zhong-Fa Tao Meng-Guang Fan Mu-Heta Aishan Zeng-Qiang Kou Qiu-Lan Chen Wen-Wu Yin Yan-Ping Zhang |
| author_facet | Qing-Nan Shi Hui-Jie Qin Qiao-Shan Lu Shu Li Zhong-Fa Tao Meng-Guang Fan Mu-Heta Aishan Zeng-Qiang Kou Qiu-Lan Chen Wen-Wu Yin Yan-Ping Zhang |
| author_sort | Qing-Nan Shi |
| collection | DOAJ |
| description | Abstract Background Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients. Methods A multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation. Results A total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5–58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906–8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176–2.384), arthralgia (OR = 3.197, 95% CI 1.986–5.148), eye bulging pain (OR = 3.482, 95% CI 1.349–8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310–2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145–2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%). Conclusions More than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers. |
| first_indexed | 2024-03-07T14:34:30Z |
| format | Article |
| id | doaj.art-00b7fabc4cd2491aa8c79ea5b42b55f3 |
| institution | Directory Open Access Journal |
| issn | 2049-9957 |
| language | English |
| last_indexed | 2024-03-07T14:34:30Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Diseases of Poverty |
| spelling | doaj.art-00b7fabc4cd2491aa8c79ea5b42b55f32024-03-05T20:43:04ZengBMCInfectious Diseases of Poverty2049-99572024-02-0113111010.1186/s40249-024-01186-4Incidence and warning signs for complications of human brucellosis: a multi-center observational study from ChinaQing-Nan Shi0Hui-Jie Qin1Qiao-Shan Lu2Shu Li3Zhong-Fa Tao4Meng-Guang Fan5Mu-Heta Aishan6Zeng-Qiang Kou7Qiu-Lan Chen8Wen-Wu Yin9Yan-Ping Zhang10National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and PreventionSchool of Public Health, Guangxi Medical UniversitySchool of Public Health, Guangxi Medical UniversityNanning Center for Disease Control and PreventionGuizhou Center for Disease Control and PreventionInner Mongolia Center for Disease Control and PreventionXinjiang Uighur Autonomous Region Center for Disease Control and PreventionShandong Center for Disease Control and PreventionNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and PreventionNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and PreventionNational Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and PreventionAbstract Background Brucellosis is a severe zoonotic disease that is often overlooked, particularly in impoverished countries. Timely identification of focal complications in brucellosis is crucial for improving treatment outcomes. However, there is currently a lack of established indicators or biomarkers for diagnosing these complications. Therefore, this study aimed to investigate potential warning signs of focal complications in human brucellosis, with the goal of providing practical parameters for clinicians to aid in the diagnosis and management of patients. Methods A multi-center cross-sectional study was conducted in China from December 2019 to August 2021. The study aimed to investigate the clinical characteristics and complications of patients with brucellosis using a questionnaire survey and medical record system. The presence of warning signs for complications was assessed using univariate and multivariate logistic regression models. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used for variable screening and model evaluation. Results A total of 880 participants diagnosed with human brucellosis were enrolled. The median age of the patients was 50 years [interquartile range (IQR): 41.5–58.0], and 54.8% had complications. The most common organ system affected by complications was the osteoarticular system (43.1%), with peripheral arthritis (30.0%), spondylitis (16.6%), paravertebral abscess (5.0%), and sacroiliitis (2.7%) being the most prevalent. Complications in other organ systems included the genitourinary system (4.7%), respiratory system (4.7%), and hematologic system (4.6%). Several factors were found to be associated with focal brucellosis. These factors included a long delay in diagnosis [odds ratio (OR) = 3.963, 95% confidence interval (CI) 1.906–8.238 for > 90 days], the presence of underlying disease (OR = 1.675, 95% CI 1.176–2.384), arthralgia (OR = 3.197, 95% CI 1.986–5.148), eye bulging pain (OR = 3.482, 95% CI 1.349–8.988), C-reactive protein (CRP) > 10 mg/L (OR = 1.910, 95% CI 1.310–2.784) and erythrocyte sedimentation rate (ESR) elevation (OR = 1.663, 95% CI 1.145–2.415). The optimal cutoff value in ROC analysis was > 5.4 mg/L for CRP (sensitivity 73.4% and specificity 51.9%) and > 25 mm/h for ESR (sensitivity 47.9% and specificity 71.1%). Conclusions More than 50% of patients with brucellosis experienced complications. Factors such as diagnostic delay, underlying disease, arthralgia, eye pain, and elevated levels of CRP and ESR were identified as significant markers for the development of complications. Therefore, patients presenting with these conditions should be closely monitored for potential complications, regardless of their culture results and standard tube agglutination test titers.https://doi.org/10.1186/s40249-024-01186-4BrucellosisComplicationsClinical spectrumWarning signs |
| spellingShingle | Qing-Nan Shi Hui-Jie Qin Qiao-Shan Lu Shu Li Zhong-Fa Tao Meng-Guang Fan Mu-Heta Aishan Zeng-Qiang Kou Qiu-Lan Chen Wen-Wu Yin Yan-Ping Zhang Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China Infectious Diseases of Poverty Brucellosis Complications Clinical spectrum Warning signs |
| title | Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China |
| title_full | Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China |
| title_fullStr | Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China |
| title_full_unstemmed | Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China |
| title_short | Incidence and warning signs for complications of human brucellosis: a multi-center observational study from China |
| title_sort | incidence and warning signs for complications of human brucellosis a multi center observational study from china |
| topic | Brucellosis Complications Clinical spectrum Warning signs |
| url | https://doi.org/10.1186/s40249-024-01186-4 |
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