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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Human brucellosis: sero-prevalence and associated risk factors in agro-pastoral communities of Kiboga District, Central Uganda

Authors: Gabriel Tumwine, Enock Matovu, John David Kabasa, David Okello Owiny, Samuel Majalija

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Brucellosis remains a neglected zoonotic disease among agro-pastoral communities where unprocessed milk and milk products are consumed. A cross-sectional study was carried out in Kiboga district to determine the seroprevalence and risk factors associated with human brucellosis in communities where livestock rearing in a common practice.

Methods

A total of 235 participants were involved in the study. Blood samples from the participants were collected and screened for Brucella using Serum Agglutination Test and Rose Bengal Plate Test. A questionnaire was used to collect data on socio-demographic characteristics and human brucellosis related risk factors.

Results

Human Brucella seroprevalence was at 17.0 % (n = 235). The prevalence was highest among males (20.5 %, n = 78) and the elderly - above 60 years (22.2 %, n = 18). Residence in rural areas (OR 3.16, 95 % CI: 1.16–8.56), consuming locally processed milk products (OR 2.54, 95 % CI: 1.12–5.78) and being single (OR 2.44, 95 % CI: 1.05–5.68), were associated with increased risk of brucellosis.

Discussion

Human brucellosis seroprevalence was high at 17 %, this was parallel with animal brucellosis prevalence that has been reported to range from 10.2 % to 25.7 % in cattle in the region. The participants were from communities known to habitually consume raw milk and milk products, know to process milk products using bare hands which are major risk factors for brucellosis in humans. This also explains why consumption of unpasteurized milk products was associated with the occurrence of brucellosis in study area. This strengthened the argument that humans get infected through consumption of contaminated animal products as reported in other earlier studies. Males and elderly being more affected because of traditional roles of these groups they play in livestock care and management. The single were also to be more associated to brucellosis, due to the fact that this group consume milk and milk products more as it is readily available in the informal markets as highly nutritious fast foods in this community as also observed in USA.

Conclusions

Brucellosis is highly prevalent in Kiboga district, and therefore, an important public health problem. The transmission risk was aggravated by consumption of unpasteurized milk products, residing in rural settings and being single. There is a need to initiate screening, treat infected humans early, and educate the public about risk factors and appropriate preventive measures of brucellosis.
Literature
2.
3.
go back to reference Makita K, Eric FM, Waiswa C, Kaboyo W, Mark EC, Susan WC. Spatial epidemiology of hospital-diagnosed brucellosis in Kampala, Uganda. Int J Health Geogr. 2011;10:52.CrossRefPubMedPubMedCentral Makita K, Eric FM, Waiswa C, Kaboyo W, Mark EC, Susan WC. Spatial epidemiology of hospital-diagnosed brucellosis in Kampala, Uganda. Int J Health Geogr. 2011;10:52.CrossRefPubMedPubMedCentral
4.
go back to reference Godfroid J, Scholz HC, Barbier T, Niclas C, Wattiau P, Fretin D, et al. Brucellosis at the animal/ecosystem/human interface at the beginning of the 21st century. Prev Vet Med. 2011;1–14. Godfroid J, Scholz HC, Barbier T, Niclas C, Wattiau P, Fretin D, et al. Brucellosis at the animal/ecosystem/human interface at the beginning of the 21st century. Prev Vet Med. 2011;1–14.
5.
go back to reference Makita K, Fevre EM, Waiswa C, Kaboyo W, De Clare Bronsvoort BM, Eisler MC, et al. Human brucellosis in urban and peri-urban areas of Kampala, Uganda. Animal Biodiversity and Emerging Diseases. Prediction and Prevention. 2008;1149:309–11. Makita K, Fevre EM, Waiswa C, Kaboyo W, De Clare Bronsvoort BM, Eisler MC, et al. Human brucellosis in urban and peri-urban areas of Kampala, Uganda. Animal Biodiversity and Emerging Diseases. Prediction and Prevention. 2008;1149:309–11.
7.
go back to reference Abdussalam M, Fein DA. Brucellosis as a world problem. Dev Biol Stand. 1976;31:9–23.PubMed Abdussalam M, Fein DA. Brucellosis as a world problem. Dev Biol Stand. 1976;31:9–23.PubMed
8.
9.
go back to reference Godfroid J, Cloeckaert A, Liautard JP, Kohler S, Fretin D, Walravens K, et al. From the discovery of the Malta fever’s agent to the discovery of a marine mammal reservoir, brucellosis has continuously been a re-emerging zoonosis. Vet Res. 2005;36:313–26.CrossRefPubMed Godfroid J, Cloeckaert A, Liautard JP, Kohler S, Fretin D, Walravens K, et al. From the discovery of the Malta fever’s agent to the discovery of a marine mammal reservoir, brucellosis has continuously been a re-emerging zoonosis. Vet Res. 2005;36:313–26.CrossRefPubMed
10.
go back to reference Kunda J, Fitzpatrick J, Kazwala R, French NP, Shirima G, et al. Health-seeking behaviour of human brucellosis cases in rural Tanzania. BMC Public Health. 2007;7:315.CrossRefPubMedPubMedCentral Kunda J, Fitzpatrick J, Kazwala R, French NP, Shirima G, et al. Health-seeking behaviour of human brucellosis cases in rural Tanzania. BMC Public Health. 2007;7:315.CrossRefPubMedPubMedCentral
11.
go back to reference McDermont JJ, Arimi SM. Brucellosis in sub-Saharan Africa: epidemiology, control and impact. Vet Microbiol. 2002;20:111–34.CrossRef McDermont JJ, Arimi SM. Brucellosis in sub-Saharan Africa: epidemiology, control and impact. Vet Microbiol. 2002;20:111–34.CrossRef
12.
go back to reference Mutanda LN. Selected laboratory tests in febrile patients in Kampala, Uganda. East Afr Med J. 1998;75:68–72.PubMed Mutanda LN. Selected laboratory tests in febrile patients in Kampala, Uganda. East Afr Med J. 1998;75:68–72.PubMed
13.
go back to reference Dames S, Tonnerre C, Saint S, Jones SR. Clinical problem-solving. Don’t know much about history. N Engl J Med. 2005;352:2338–42.CrossRefPubMed Dames S, Tonnerre C, Saint S, Jones SR. Clinical problem-solving. Don’t know much about history. N Engl J Med. 2005;352:2338–42.CrossRefPubMed
14.
go back to reference Andriopoulos P, Tsironi M, Deftereos S, Aessopos A, Assimakopoulos G. Acute brucellosis: presentation, diagnosis, and treatment of 144 cases. Int J Infect Dis. 2007;11:52–7.CrossRefPubMed Andriopoulos P, Tsironi M, Deftereos S, Aessopos A, Assimakopoulos G. Acute brucellosis: presentation, diagnosis, and treatment of 144 cases. Int J Infect Dis. 2007;11:52–7.CrossRefPubMed
15.
go back to reference Bingöl A, Yücemen N, Meço O. Medically treated intraspinal “Brucella” granuloma. Surg Neurol. 1999;52:570–6.CrossRefPubMed Bingöl A, Yücemen N, Meço O. Medically treated intraspinal “Brucella” granuloma. Surg Neurol. 1999;52:570–6.CrossRefPubMed
16.
go back to reference María Pía F, Maximilian M, Gilman RH, Smits HL. Human brucellosis, Review. Lancet Infect Dis. 2007;7:775–86.CrossRef María Pía F, Maximilian M, Gilman RH, Smits HL. Human brucellosis, Review. Lancet Infect Dis. 2007;7:775–86.CrossRef
17.
go back to reference Uddin MJ, Sanyal SC, Mustafa AS, et al. The role of aggressive medical therapy along with early surgical intervention in the cure of Brucella endocarditis. Ann Thorac Cardiovasc Surg. 1998;4:209–13.PubMed Uddin MJ, Sanyal SC, Mustafa AS, et al. The role of aggressive medical therapy along with early surgical intervention in the cure of Brucella endocarditis. Ann Thorac Cardiovasc Surg. 1998;4:209–13.PubMed
19.
go back to reference Roop RM, Gaines JM, Anderson ES, Caswell CC, Martin DW. Survival of the fittest: how Brucella strains adapt to their intracellular niche in the host. Med Microbiol Immunol. 2009;198:221–38.CrossRefPubMed Roop RM, Gaines JM, Anderson ES, Caswell CC, Martin DW. Survival of the fittest: how Brucella strains adapt to their intracellular niche in the host. Med Microbiol Immunol. 2009;198:221–38.CrossRefPubMed
20.
go back to reference Franco MP, Mulder M, Gilman RH, Smits HL. Review: Human Brucellosis. Lancet Infect Dis. 2007;7:775–86.CrossRefPubMed Franco MP, Mulder M, Gilman RH, Smits HL. Review: Human Brucellosis. Lancet Infect Dis. 2007;7:775–86.CrossRefPubMed
21.
go back to reference Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6:91–9.CrossRefPubMed Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6:91–9.CrossRefPubMed
22.
go back to reference Mangen MJ, Otte J, Pfeiffer D, Chilonda P. Bovine brucellosis in Sub Saharan Africa. Estimation of seroprevalence and impact on meat and milk off take potential, Livestock Policy Discussion Paper No. 8. FAO Livestock Information and Policy Branch, AGA. Available www.fao.org/3/a-ag274e.pdf (Accessed on 29/06/2014). 2002. Mangen MJ, Otte J, Pfeiffer D, Chilonda P. Bovine brucellosis in Sub Saharan Africa. Estimation of seroprevalence and impact on meat and milk off take potential, Livestock Policy Discussion Paper No. 8. FAO Livestock Information and Policy Branch, AGA. Available www.​fao.​org/​3/​a-ag274e.​pdf (Accessed on 29/06/2014). 2002.
23.
go back to reference Swai ES, Schoonman L. Human brucellosis: seroprevalence and risk factors related to high risk occupational groups in Tanga Municipality, Tanzania. Zoonoses Public Health. 2009;56:183–7.CrossRefPubMed Swai ES, Schoonman L. Human brucellosis: seroprevalence and risk factors related to high risk occupational groups in Tanga Municipality, Tanzania. Zoonoses Public Health. 2009;56:183–7.CrossRefPubMed
26.
go back to reference Makita K, Eric FM, Waiswa C, Mark EC, Thrusfield M, Susan WC. Herd prevalence of bovine brucellosis and analysis of risk factors in cattle in urban and peri-urban areas of the Kampala economic zone, Uganda. BMC Vet Res. 2011;7:1–8.CrossRef Makita K, Eric FM, Waiswa C, Mark EC, Thrusfield M, Susan WC. Herd prevalence of bovine brucellosis and analysis of risk factors in cattle in urban and peri-urban areas of the Kampala economic zone, Uganda. BMC Vet Res. 2011;7:1–8.CrossRef
27.
go back to reference Egaru D, Zirintunda G, Ekou J. Seroprevalence of brucellosis in cattle of Arapai Sub-County of Soroti, Uganda. J Exp Biol Agric Sci. 2013;1:1–6. Egaru D, Zirintunda G, Ekou J. Seroprevalence of brucellosis in cattle of Arapai Sub-County of Soroti, Uganda. J Exp Biol Agric Sci. 2013;1:1–6.
28.
go back to reference Mugabi R. Brucellosis epidemiology, virulence factors, control and molecular targets to prevent bacterial infectious diseases. Masters thesis, submitted to the Graduate Faculty of the North Dakota State University of Agriculture and Applied Science. 2012. Mugabi R. Brucellosis epidemiology, virulence factors, control and molecular targets to prevent bacterial infectious diseases. Masters thesis, submitted to the Graduate Faculty of the North Dakota State University of Agriculture and Applied Science. 2012.
29.
go back to reference Nabukenya I, Kaddu-Mulindwa D, Nasinyama GW. Survey of Brucella infection and malaria among Abattoir workers in Kampala and Mbarara Districts, Uganda. BMC Public Health. 2013;13:901.CrossRefPubMedPubMedCentral Nabukenya I, Kaddu-Mulindwa D, Nasinyama GW. Survey of Brucella infection and malaria among Abattoir workers in Kampala and Mbarara Districts, Uganda. BMC Public Health. 2013;13:901.CrossRefPubMedPubMedCentral
30.
go back to reference Hartigan P. Human brucellosis: epidemiology and clinical manifestations. Ir Vet J. 1997;50:179–80. Hartigan P. Human brucellosis: epidemiology and clinical manifestations. Ir Vet J. 1997;50:179–80.
31.
go back to reference Staal SJ, Kaguongo WN. The Ugandan dairy subsector targeting development opportunities. Nairobi, Kenya: International Livestock Research Institute (ILRI); 2003. Staal SJ, Kaguongo WN. The Ugandan dairy subsector targeting development opportunities. Nairobi, Kenya: International Livestock Research Institute (ILRI); 2003.
32.
go back to reference Kunda J, Fitzpatrick J, Kazwala R, French NP, Shirima G, MacMillan A, et al. Health-seeking behaviour of human brucellosis cases in rural Tanzania. BMC Public Health. 2007;7:315.CrossRefPubMedPubMedCentral Kunda J, Fitzpatrick J, Kazwala R, French NP, Shirima G, MacMillan A, et al. Health-seeking behaviour of human brucellosis cases in rural Tanzania. BMC Public Health. 2007;7:315.CrossRefPubMedPubMedCentral
33.
34.
go back to reference UBOS/MAAIF. Summary report of the national livestock census 2008. Kampala, Uganda: Uganda Bureau of Statistics/Ministry of Agriculture Animal Industry and Fisheries; 2009. UBOS/MAAIF. Summary report of the national livestock census 2008. Kampala, Uganda: Uganda Bureau of Statistics/Ministry of Agriculture Animal Industry and Fisheries; 2009.
35.
go back to reference Martin SW, Meek AH, Willeberg P. Veterinary epidemiology; principles and methods. Ames: Iowa State Univesrity Press; 1987. p. 31–46. Martin SW, Meek AH, Willeberg P. Veterinary epidemiology; principles and methods. Ames: Iowa State Univesrity Press; 1987. p. 31–46.
36.
go back to reference Alton GG, Jones LM, Angus RD, Verger JM. Serological methods. In: Alton GG, editor. Techniques for the brucellosis laboratory. Paris, France: Institute National de la Recherche Agronomique; 1988. Alton GG, Jones LM, Angus RD, Verger JM. Serological methods. In: Alton GG, editor. Techniques for the brucellosis laboratory. Paris, France: Institute National de la Recherche Agronomique; 1988.
37.
go back to reference Al Dahouk S, Tomaso H, Nockler K, Neubauer H, Frangoulidis D. Laboratory-based diagnosis of brucellosis-a review of the literature. Part II: serological tests for brucellosis. Clin Lab. 2003;49:577–89.PubMed Al Dahouk S, Tomaso H, Nockler K, Neubauer H, Frangoulidis D. Laboratory-based diagnosis of brucellosis-a review of the literature. Part II: serological tests for brucellosis. Clin Lab. 2003;49:577–89.PubMed
39.
go back to reference Ruiz-Mesa JD, Sanchez-Gonzalez J, Reguera JM, Martin L, Lopez-Palmero S, Colmenero JD. Rose Bengal test: diagnostic yield and use for the rapid diagnosis of human brucellosis in emergency departments in endemic areas. Clin Microbiol Infect. 2005;11:221–5.CrossRefPubMed Ruiz-Mesa JD, Sanchez-Gonzalez J, Reguera JM, Martin L, Lopez-Palmero S, Colmenero JD. Rose Bengal test: diagnostic yield and use for the rapid diagnosis of human brucellosis in emergency departments in endemic areas. Clin Microbiol Infect. 2005;11:221–5.CrossRefPubMed
40.
go back to reference Kohei M, Eric FM, Charles W, Mark EC, Susan WC. How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk. PLoS ONE. 2010;5(12):1–10. Kohei M, Eric FM, Charles W, Mark EC, Susan WC. How human brucellosis incidence in urban Kampala can be reduced most efficiently? A stochastic risk assessment of informally-marketed milk. PLoS ONE. 2010;5(12):1–10.
41.
go back to reference Maichomo MW, McDermott JJ, Arimi SM, Gathura PB, Mugambi TJ, Muriuki SM. Study of brucellosis in a pastoral community and evaluation of the usefulness of clinical signs and symptoms in differentiating it from other flu-like diseases. Afr J Health Sci. 2000;7(18):114–9.PubMed Maichomo MW, McDermott JJ, Arimi SM, Gathura PB, Mugambi TJ, Muriuki SM. Study of brucellosis in a pastoral community and evaluation of the usefulness of clinical signs and symptoms in differentiating it from other flu-like diseases. Afr J Health Sci. 2000;7(18):114–9.PubMed
42.
go back to reference Muriuki SM, McDermott JJ, Arimi SM, Mugambi JT, Wamola IA. Criteria for better detection of brucellosis in the Narok district of Kenya. East Afr Med J. 1997;74:317–20.PubMed Muriuki SM, McDermott JJ, Arimi SM, Mugambi JT, Wamola IA. Criteria for better detection of brucellosis in the Narok district of Kenya. East Afr Med J. 1997;74:317–20.PubMed
44.
go back to reference Omore AO, Muriuki H, Kenyanjui M, Owango M, Staal SJ. The dairy sub-sector: a rapid appraisal: research report of the MoA/KARI/ILRI smallholder dairy project, Nairobi. Nairobi, Kenya: International Livestock Research Institute; 1999. Omore AO, Muriuki H, Kenyanjui M, Owango M, Staal SJ. The dairy sub-sector: a rapid appraisal: research report of the MoA/KARI/ILRI smallholder dairy project, Nairobi. Nairobi, Kenya: International Livestock Research Institute; 1999.
46.
go back to reference Masomeh S, Arezoo A, Ali Akbar V, Mohammad B, Ali E, Amitis R. Risk factors for human brucellosis in Iran: a case–control study. Int J Infect Dis. 2008;12:157–61.CrossRef Masomeh S, Arezoo A, Ali Akbar V, Mohammad B, Ali E, Amitis R. Risk factors for human brucellosis in Iran: a case–control study. Int J Infect Dis. 2008;12:157–61.CrossRef
47.
go back to reference Husseini AS, Ramlawi AM. Brucellosis in the West Bank, Palestine. Saudi Med J. 2004;25:1640–3.PubMed Husseini AS, Ramlawi AM. Brucellosis in the West Bank, Palestine. Saudi Med J. 2004;25:1640–3.PubMed
48.
go back to reference Kalaajieh WK. Epidemiology of human brucellosis in Lebanon in 1997. Med Mal Infect. 2000;30:43–6.CrossRef Kalaajieh WK. Epidemiology of human brucellosis in Lebanon in 1997. Med Mal Infect. 2000;30:43–6.CrossRef
49.
go back to reference Elbeltagy K. An epidemiological profile of brucellosis in Tabuk Province, Saudi Arabia. East Mediterr Health J. 2001;7:790–8. Elbeltagy K. An epidemiological profile of brucellosis in Tabuk Province, Saudi Arabia. East Mediterr Health J. 2001;7:790–8.
50.
go back to reference Omore AO, Arimi SM, Kan’gethe E, McDermott JJ, Staal SJ, Ouma E, et al. Assessing and managing milkborne health risks for the benefit of consumers in Kenya. Nairobi: International Livestock Research Institute; 2002. Omore AO, Arimi SM, Kan’gethe E, McDermott JJ, Staal SJ, Ouma E, et al. Assessing and managing milkborne health risks for the benefit of consumers in Kenya. Nairobi: International Livestock Research Institute; 2002.
51.
go back to reference Hendricks MK, Perez EM, Burger PJ, Mouton PA. Brucellosis in childhood in Western Cape. S Afr Med J. 1995;85:176–8.PubMed Hendricks MK, Perez EM, Burger PJ, Mouton PA. Brucellosis in childhood in Western Cape. S Afr Med J. 1995;85:176–8.PubMed
52.
go back to reference Cooper CW. Risk factors in transmission of brucellosis from animals to humans in Saudi Arabia. Trans R Soc Trop Med Hyg. 1992;86:206–9.CrossRefPubMed Cooper CW. Risk factors in transmission of brucellosis from animals to humans in Saudi Arabia. Trans R Soc Trop Med Hyg. 1992;86:206–9.CrossRefPubMed
53.
go back to reference Kozukeev TB AS, Maes E, Favorov M, Centers for Disease, Control PC. Risk factors for brucellosis--Leylek and Kadamjay districts, Batken Oblast, Kyrgyzstan, January-November, 2003. MMWR Morb Mortal Wkly Rep. 2006;55 Suppl 1:31–4. Kozukeev TB AS, Maes E, Favorov M, Centers for Disease, Control PC. Risk factors for brucellosis--Leylek and Kadamjay districts, Batken Oblast, Kyrgyzstan, January-November, 2003. MMWR Morb Mortal Wkly Rep. 2006;55 Suppl 1:31–4.
54.
go back to reference Mishal J, Ben-Israel N, Levin Y, Sherf S, Jafari J, Embon E, et al. Brucellosis outbreak: analysis of risk factors and serologic screening. Int J Mol Med. 1999;4(6):655–8.PubMed Mishal J, Ben-Israel N, Levin Y, Sherf S, Jafari J, Embon E, et al. Brucellosis outbreak: analysis of risk factors and serologic screening. Int J Mol Med. 1999;4(6):655–8.PubMed
55.
go back to reference Abdollahia A, Mortezab A, Khalilzadehb O, Rasoulinejad M. Brucellosis serology in HIV-infected patients. Int J Infect Dis. 2010;14(10):e904–6.CrossRef Abdollahia A, Mortezab A, Khalilzadehb O, Rasoulinejad M. Brucellosis serology in HIV-infected patients. Int J Infect Dis. 2010;14(10):e904–6.CrossRef
56.
go back to reference Rahman AK, Dirk B, Fretin D, Saegerman C, Ahmed MU, Muhammad N, et al. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh. Foodborne Pathog Dis. 2012;9:190–7.CrossRefPubMed Rahman AK, Dirk B, Fretin D, Saegerman C, Ahmed MU, Muhammad N, et al. Seroprevalence and risk factors for brucellosis in a high-risk group of individuals in Bangladesh. Foodborne Pathog Dis. 2012;9:190–7.CrossRefPubMed
57.
go back to reference Schelling E, Diguimbaye C, Daoud S, Nicolet J, Boerlin P, Tanner M, et al. Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad. Prev Vet Med. 2003;61(4):279–93.CrossRefPubMed Schelling E, Diguimbaye C, Daoud S, Nicolet J, Boerlin P, Tanner M, et al. Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad. Prev Vet Med. 2003;61(4):279–93.CrossRefPubMed
58.
go back to reference Kunda J, Julie F, Nigel F, Rudovick K, Dominic K, Mfinanga GS, et al. Quantifying risk factors for human brucellosis in rural northern Tanzania. PLoS One. 2010;5(4):e9968.CrossRef Kunda J, Julie F, Nigel F, Rudovick K, Dominic K, Mfinanga GS, et al. Quantifying risk factors for human brucellosis in rural northern Tanzania. PLoS One. 2010;5(4):e9968.CrossRef
59.
go back to reference Gur A, Geyik MF, Dikici B, Nas K, Cevik R, Sarac J, et al. Complications of brucellosis in different age groups: a study of 283 cases in Southeastern Anatolia of Turkey. Yonsei Med J. 2003;44:33–44.CrossRefPubMed Gur A, Geyik MF, Dikici B, Nas K, Cevik R, Sarac J, et al. Complications of brucellosis in different age groups: a study of 283 cases in Southeastern Anatolia of Turkey. Yonsei Med J. 2003;44:33–44.CrossRefPubMed
60.
go back to reference Jennings GJ, Hajjeh RA, Girgis FY, Fadeel MA, Maksoud MA, Wasfy MO, et al. Brucellosis as a cause of acute febrile illness in Egypt. Trans R Soc Trop Med Hyg. 2007;101:707–13.CrossRefPubMed Jennings GJ, Hajjeh RA, Girgis FY, Fadeel MA, Maksoud MA, Wasfy MO, et al. Brucellosis as a cause of acute febrile illness in Egypt. Trans R Soc Trop Med Hyg. 2007;101:707–13.CrossRefPubMed
61.
go back to reference Alballa SR. Epidemiology of human brucellosis in southern Saudi Arabia. J Trop Med Hyg. 1995;98:185–9.PubMed Alballa SR. Epidemiology of human brucellosis in southern Saudi Arabia. J Trop Med Hyg. 1995;98:185–9.PubMed
62.
go back to reference Ayyaz S, Badar H, Ghafoor A. Level & determinants of consumers’ perception of packed milk in Pakistan. J Bus Econ. 2011;3:60–76. Ayyaz S, Badar H, Ghafoor A. Level & determinants of consumers’ perception of packed milk in Pakistan. J Bus Econ. 2011;3:60–76.
Metadata
Title
Human brucellosis: sero-prevalence and associated risk factors in agro-pastoral communities of Kiboga District, Central Uganda
Authors
Gabriel Tumwine
Enock Matovu
John David Kabasa
David Okello Owiny
Samuel Majalija
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2242-z

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