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Volume 22, Number 12—December 2016
Dispatch

Human Brucellosis in Febrile Patients Seeking Treatment at Remote Hospitals, Northeastern Kenya, 2014–2015

John NjeruComments to Author , Falk Melzer, Gamal Wareth, Hosny El-Adawy, Klaus Henning, Mathias W. Pletz, Regine Heller, Samuel Kariuki, Eric M. Fèvre, and Heinrich Neubauer
Author affiliations: Friedrich-Loeffler-Institut, Jena, Germany (J. Njeru, F. Melzer, G. Wareth, H. El-Adawy, K. Henning, H. Neubauer); Friedrich Schiller University, Jena (J. Njeru, M.W. Pletz, R. Heller); Kenya Medical Research Institute, Nairobi, Kenya (J. Njeru, S. Kariuki); Benha University, Moshtohor, Egypt (G. Wareth); Kafrelsheikh University, Kafr El-Sheikh, Egypt (H. El-Adawy); University of Liverpool, Liverpool, United Kingdom (E. Fèvre); International Livestock Research Institute, Nairobi (E. Fèvre)

Main Article

Table 1

Selected characteristics of study participants and number of febrile patients with Brucella-positive test results, northeastern Kenya, 2014–2015*

Characteristic No. (%) patients
 p value Crude OR (95% CI)
Positive for brucellosis, n = 146
 Negative for brucellosis, n = 921
Mean age, y, + SD
 34.8 + 11.5
 33.9 + 12.6
 0.863
 NA
Age group, y
<19 16 (11.0) 127 (13.8) NA Referent
20–29 31 (21.2) 206 (22.4) 0.418 1.29 (0.70–2.39)
30–39 48 (32.9) 265 (28.8) 0.063 1.75 (0.97–3.08)
40–49 38 (26.0) 196 (21.3) 0.169 1.52 (0.84–2.76)
>50
 13 (8.9)
 127 (13.8)
 0.764
 0.90 (0.43–1.84)
Male sex 86 (58.9) 401 (43.5) 0.001 1.98 (1.30–2.68)
Wajir County resident
 81 (55.5)
 440 (49.4)
 0.201
 1.34 (0.97–1.77)
Occupation
Herder 109 (74.7) 569 (61.8) 0.002 3.81 (2.17–12.38)
Civil servant 16 (11.0) 126 (13.7) 0.199 2.53 (0.71–8.91)
General business 7 (4.8) 67 (7.3) 0.286 1.98 (0.49–7.85)
Student 6 (4.1) 56 (6.1) 0.308 2.08 (0.51–8.48)
Livestock trader 6 (4.1) 53 (5.8) 0.053 3.74 (0.98–14.26)
Other
 2 (1.4)
 50 (5.4)
 NA
 Referent
Education level
None 98 (67.1) 563 (61.1) NA Referent
Primary 25 (17.1) 181 (19.7) 0.335 0.79 (0.51–1.27)
Secondary 16 (11.0) 104 (11.3) 0.670 0.88 (0.69–1.56)
Post-secondary
 7 (4.8)
 73 (7.9
 0.146
 0.56 (0.25–1.32)
Somali ethnic group member
 133 (91.1)
 830 (90.1)
 0.712
 1.12 (0.62–2.63)
Clinical symptoms and signs
Headache 113 (77.4) 836 (90.8) 0.504 1.45 (0.63–3.12)
Chills 93 (63.7) 482 (52.3) 0.065 1.79 (0.93–2.58)
Arthralgia/myalgia 118 (80.8) 699 (75.9) 0.322 1.48 (0.78–1.85)
Malaise/fatigue 101 (69.2) 646 (70.1) 0.018 2.20 (1.44–4.31)
Anorexia 63 (43.2) 514 (55.8) 0.610 0.91 (0.56–1.93)
Respiratory tract infection 34 (23.3) 263 (28.6) 0.434 1.03 (0.69–1.60)
Constipation 22 (15.1) 171 (18.6) 0.301 1.08 (0.83–3.11)
Night sweats 11 (7.5) 159 (17.3) 0.181 0.90 (0.67–5.90)
Diarrhea 8 (5.5) 106 (11.5) 0.120 0.95 (0.86–2.89)
Weight loss 12 (8.2) 105 (11.4) 0.228 1.24 (0.81- 6.04)
Confusion† 3 (2.3) 42 (5.3) 0.337 0.96 (0.60–2.91)
Rash 3 (2.1) 40 (4.3) 0.172 0.74 (0.22–1.55)
Vomiting 4 (2.7) 28 (3.0) 0.582 0.85 (0.36–1.98)
Abdominal pain 52 (35.6) 215 (23.3) 0.007 1.92 (1.35–5.64)
Hepatomegaly/splenomegaly 33 (22.6) 103 (11.1) 0.011 2.01 (1.63–8.10)
History of fever, >14 d
 75 (51.4)
 326 (35.3)
 <0.001
 3.71 (2.75–10.94)
Provisional diagnosis‡
Typhoid fever 63 (43.2) 371 (45.0) 0.671 NA
Malaria 30 (20.5) 252 (30.5) 0.079 NA
Pneumonia 12 (8.2) 114 (13.8) 0.084 NA
Other§
 14 (9.6)
 Undefined
 NA
 NA
Days since fever onset/median 24.5/16 13.0/8 <0.001 NA

*NA, not available; OR, odds ratio.
†Data available for adult and adolescent patients only.
‡includes clinical diagnosis made by attending hospital clinician.
§Data not available for all patients.

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Page created: November 18, 2016
Page updated: November 18, 2016
Page reviewed: November 18, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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