Human Brucellosis in Rural Uganda: Clinical Manifestations, Diagnosis, and Comorbidities at Kabale Regional Referral Hospital, Kabale, Uganda

Open Forum Infect Dis. 2017 Nov 1;4(4):ofx237. doi: 10.1093/ofid/ofx237. eCollection 2017 Fall.

Abstract

Background: Brucellosis is a zoonotic infection transmitted to humans through direct contact with infected animals, their products, or excreta such as urine or dung. Brucellosis is associated with significant morbidity in Southwestern Uganda, where cattle and goat rearing are a major economic industry. As in many settings in sub-Saharan Africa, diagnosis and management of brucellosis remain a challenge due to the presence of comorbidities and limitations in resources for diagnostic testing and therapy.

Methods: A chart review was conducted to characterize the clinical manifestations, diagnosis, comorbidities, and management of 101 patients treated for brucellosis at the Kabale Regional Referral Hospital from September 2002 to May 2010.

Results: Patients presented with substantial comorbidities. The most common manifestation of illness was osteoarticular, but disease manifestations were quite varied. A high rate of focal illness in this cohort (77%) was observed.

Conclusions: Clinicians in this setting should be cognizant of the varied presentations, comorbidities, and treatment options for this disease.

Keywords: Uganda; brucellosis/complications; developing countries; global health; zoonoses.