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      Clinical manifestations of human brucellosis: a systematic review and meta-analysis.

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          Abstract

          The objectives of this systematic review, commissioned by WHO, were to assess the frequency and severity of clinical manifestations of human brucellosis, in view of specifying a disability weight for a DALY calculation.

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          Quantifying the burden of disease: the technical basis for disability-adjusted life years.

          C. Murray (1994)
          Detailed assumptions used in constructing a new indicator of the burden of disease, the disability-adjusted life year (DALY), are presented. Four key social choices in any indicator of the burden of disease are carefully reviewed. First, the advantages and disadvantages of various methods of calculating the duration of life lost due to a death at each age are discussed. DALYs use a standard expected-life lost based on model life-table West Level 26. Second, the value of time lived at different ages is captured in DALYs using an exponential function which reflects the dependence of the young and the elderly on adults. Third, the time lived with a disability is made comparable with the time lost due to premature mortality by defining six classes of disability severity. Assigned to each class is a severity weight between 0 and 1. Finally, a three percent discount rate is used in the calculation of DALYs. The formula for calculating DALYs based on these assumptions is provided.
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            Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature.

            Turan Buzgan, Mustafa Kasım Karahocagil, Hasan Irmak … (2010)
            Brucellosis is the most prevalent bacterial zoonosis worldwide. In this study, we aimed to compare our 1028 brucellosis cases with other big series in the literature in view of epidemiological, clinical, and laboratory findings and therapeutic features. A total of 1028 brucellosis cases admitted to the Department of Infectious Diseases and Clinical Microbiology over a 10-year period were included in the study. A retrospective analysis was undertaken and patient files were reviewed for history, clinical and laboratory findings, and therapeutic features, as well as complications. Of the 1028 patients, 539 (52.4%) were female and 489 (47.6%) were male. The mean age of patients was 33.7+/-16.34 years and 69.6% of cases were aged 13-44 years. Four hundred and thirty-five cases (42.3%) had a history of raising livestock and 55.2% of the cases were found to have no occupational risk for brucellosis. Six hundred and fifty-four of the cases (63.6%) had a history of raw milk and dairy products consumption. The most frequently seen symptoms were arthralgia (73.7%) and fever (72.2%), while the most common clinical findings were fever (28.8%) and hepatomegaly (20.6%). The most frequent laboratory finding was a high C-reactive protein level (58.4%). The standard tube agglutination (STA) test+Coombs STA test was positive in 1016 cases (98.8%). Focal involvement was present in 371 (36.1%) cases. The most frequent involvement was osteoarticular involvement with 260 cases (25.3%). The overall relapse rate for patients with brucellosis was 4.7%. The highest relapse rate, 8.5%, was observed in the group of patients with osteoarticular involvement. Regimens including doxycycline and streptomycin with or without rifampin appeared more effective than other regimens in osteoarticular involvement. In humans, brucellosis may lead to serious morbidity, and it continues to be a major health problem in Turkey. There is no recommended treatment protocol for complicated brucellosis. Large multicenter studies are needed to determine the most appropriate treatment choices and durations in complicated brucellosis. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
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              Perspectives for the Treatment of Brucellosis in the 21st Century: The Ioannina Recommendations

              Javier Ariza, Mile Bosilkovski, Antonio Cascio … (2007)
              The authors provide evidence-based guidance on treating human brucellosis, and discuss the future clinical trials that would help address the controversies surrounding treatment.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): PLoS Negl Trop Dis
                Title: PLoS neglected tropical diseases
                Publisher: Public Library of Science (PLoS)
                ISSN (Electronic): 1935-2735
                ISSN (Print): 1935-2727
                Publication date (Electronic): 2012
                Volume: 6
                Issue: 12
                Affiliations
                [1 ] Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
                Article
                Publisher Item ID: PNTD-D-12-00608
                DOI: 10.1371/journal.pntd.0001929
                PMC ID: 3516581
                PubMed ID: 23236528
                SO-VID: 6d392ea1-2fd4-4eb1-9452-52ede52916a2
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