incidence rate of chronic brucellosis following one-year antibiotic therapy in Koohrang district of Chaharmahal and Bakhtyari province

ABSTRACT

Brucellosis is a common zoonotic disease with different clinical pictures such as chronic brucellosis. The aim of this study was to determine the incidence rate of chronic brucellosis after one-year of antibiotic therapy in tribal patients of Koohrang district of Chaharmahal and Bakhtyari province from 2003 to 2004. The patients with acute brucellosis were recognized using both standard tube agglutination [STA] [Wright] and 2-mercaptoethanol [2ME] tests. Also a questionnaire about demographic variables of the patients, their signs and symptoms and how they were infected was filled in by the patients. Subsequently, they were treated using conventional regimen. After one year, the patients were reviewed for the signs and symptoms of the disease and their sample sera were tested for related antibodies. The patients with specific antibody [>1/160 for both tests] regarded as positive. The data was analyzed by t, Chi square, and regression tests. During the peak of brucellosis in 2003. 119 persons were infected, 63.9% male and 36.1% female. Arthritis [88.7%] and fever [78.54%] were the most common signs and symptoms. In the second visit 97 new patients were recognized, rifampin with cotrimoxazole [57.7%] and doxycycline with rifampin [15.5%] were used for treatment of the patients. 17.5% of the patients had final titer of STA test titer and 15.5% of them had a 2ME titer higher than 1.160. 16.5% of the patients had recurrence signs and symptoms and 11.3% of them had mild symptoms. There was significant statistical relationship between antimicrobial drugs regimen and final titer of STA and 2ME tests and clinical course in the following year [p<0.001], Using both rifampin and cotrimoxazole resulted in a higher chance of chronic brucellosis [p<0.001]. The incidence rate of chronic brucellosis in this area was higher than that in the other regions of Iran and other countries. This was mainly due to lack of standard antimicrobial regimen, using single drug regimen, short-course antimicrobial therapy, low level of training of the patients and low access to health facilities in the region