Trends of Reported Human Cases of Brucellosis, Kingdom of Saudi Arabia, 2004 - 2012 Público

Abstract

Objectives: Humanbrucellosis is an important zoonotic disease and is especially concerning in the Kingdom of Saudi Arabia (KSA), where livestock importation is significant. We analyzed reported human brucellosis disease trends in KSA over time to help policymakers understand the magnitude of disease and guide the design of prevention and control measures.

Methods: Using data from the national registry of reported human brucellosis cases from the Infectious Disease Department (IDD) of the KSA Ministry of Health (MoH), we calculated the cumulative numbers by age group and month of year from 2004 - 2012. We also determined the trends of incidence rates (IRs), by gender and nationality from 2004 - 2012 and by region from 2007 - 2012. Population data came from the Ministry of Economy and Planning, Central Department of Statistics and Information.

Results: There were 37, 477 reported human brucellosis cases from 2004 - 2012. Persons 15 - 44 years of age had greater cases (19,130) than any other age group. The IRs (per 100,000 population) significantly decreased from 22.9 in 2004 (95% CI=22.3, 23.5) to 12.5 in 2012 (95% CI=12.1, 13). Males had a significantly greater IR than females.Males had an IR of 23.4 (95% CI=22.6, 24.3) and females had an IR of 22.3 (21.4, 22.2) in 2004, while in 2012, males had an IR of 15 (14.5, 15.7) and females had an IR of 9.3 (8.8, 9.8). Most cases were reported during spring and summer seasons (from March to July). In 2012, there were 536 cases reported in May, while only 225 cases were reported in January. The IR of Saudi citizens was significantly greater than that of non-Saudis, but this difference shrank over time. Saudi citizens had an IR of 27.1 (95% CI=26.4, 28) and non-Saudis had an IR of 11.5 (10.7, 12.4) in 2004, while in 2012, Saudi citizens had an IR of 13.2 (95% CI=12.7, 13.7) and non-Saudis had an IR of 11.2 (95% CI =10.5, 11.9). From 2007 - 2012, the IRs of Al-Qassim, Aseer, and Hail were in the highest 25^th percentile, while the IRs of Al-Jouf, Jazan, Makkah, and Al-Riyadh were in the lowest 25^th percentile.

Conclusion: Young, male Saudi citizens living in highly endemic areas were at greatest risk of acquiring brucellosis. We recommend vaccinating susceptible animals against brucellosis, enforcing animal importation protocols, and increasing the public's awareness of preventive measures. Additionally, the MoH should enhance and further develop the national brucellosis surveillance program.

Table of Contents

Table of Contents:

List of Figures 6
List of Tables 7
Abstract 8
Chapter 1: Introduction 9
Chapter 2: Literature Review 13
Chapter 3: Manuscript 17
A. Introduction 18
B. Methodology 19
C. Results 21
D. Discussion 27
Chapter 4: Conclusion and Recommendations 29
References 31
Appendix 34

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Palabra Clave	Incidence Rates zoonotic brucellosis One health approach Kingdom of Saudi Arabia
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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