Analysis of epidemiological and laboratory results of acute and chronic brucellosis among minors in Heilongjiang from 2016 to 2020 / 中华地方病学杂志

ABSTRACT

Objective:To analyze the epidemiological and clinical features of acute and chronic brucellosis in minors from 2016 to 2020 in Heilongjiang, and to provide evidence for diagnosis, prevention and treatment of brucellosis in minors.Methods:A retrospective analysis of the medical records of 150 hospitalized patients with brucellosis in minors from January 2016 to December 2020 was conducted in Beidahuang Industry Group General Hospital. According to clinical classification, 125 cases were acute patients and 25 cases were chronic patients. At the same time, 40 outpatient physical examination persons were selected as control group. Epidemiological features, clinical presentation and misdiagnosis of acute and chronic brucellosis in minors were analyzed and compared. The results of routine blood test, liver function test, myocardial enzyme test, whole blood C-reactive protein (CRP) and blood culture were analyzed and compared among acute group, chronic group and control group.Results:From 2016 to 2020, the proportion of brucellosis in minors was 3.26% (37/1 136), 2.50% (28/1 119), 3.31% (36/1 088), 2.80% (35/1 250) and 2.00% (14/701), respectively. In acute and chronic brucellosis, the ratios of male to female were 1.66 ∶ 1.00 (78/47) and 1.27 ∶ 1.00 (14/11); the incidence rate was highest in school age [35.2% (44/125), 44.0% (11/25)] and lowest in infant [2.4% (3/125), 0 (0/25)]; the disease were most common in March and June [52.8% (66/125), 44.0% (11/25)]; the more distribution was in Qiqihar [19.2% (24/125), 28.0% (7/25)], and the most susceptible factor was contact with cattle and sheep [89.6% (112/125), 96.0% (24/25)]. In acute group, there was 1 case of lactation infection. There were 32 cases [25.6% (32/125)] and 8 cases [32.0% (8/25)] with four typical symptoms in the two groups. High fever was the most common type in acute group [41.2% (47/114)]. Knee pain was the most common type [50.0% (36/72), 60.0% (12/20)] in both groups. The incidence of musculoskeletal pain in acute group was higher than that in chronic group (χ 2 = 4.57, P = 0.033). The rates of fatigue and joint pain in chronic group were higher than those in acute group (χ 2 = 4.49, 4.41, P < 0.05). Totally 57.3% (86/150) of patients with brucellosis were misdiagnosed as other diseases [49.3% (74/150)] in acute group and 8.0% (12/150) in chronic group] and colds were the most common, accounting for 38.0% (57/150). The positive rate of blood culture in acute group (48 cases, 38.4%) was significantly higher than that in chronic group (4 cases, 16.0%, χ 2 = 4.62, P = 0.038). Compared with control group, the levels of monocyte, alanine aminotransferase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), lactate dehydrogenase(LDH), hydroxybutyrate dehydrogenase(HBDH), creatine kinase isoenzyme(CK-MB), hemoglobin (HGB), mean corpuscular volume(MCV), mean corpuscular hemoglobin (MCH), mean corpuscular-hemoglobin concentration (MCHC), total protein (TP), albumin (ALB) in acute group and chronic group were significantly different ( P < 0.05); compared with the chronic group, CRP and LDH increased, the differences were statistically significant ( P < 0.01). Conclusions:The epidemiological characteristics and clinical symptoms of acute and chronic brucellosis in minors in Heilongjiang are different. Monocyte, erythrocyte, transaminase, TP, ALB and myocardial enzyme are changed significantly, it needs to be monitored regularly and given certain protective measures.