Background
Methods
Systematic review protocol
Literature search and data collection
Data screening
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The article reported original data on brucellosis in Kenya,
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The article provided information on occurrence ([sero-prevalence] and/or incidence) or outbreak report of Brucella spp. in animals and/or humans,
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The article described case reports/series of Brucella spp. infection in animals and/or humans,
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The article reported on control programmes,
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The publication investigated the associations of potential predisposing risk factors and Brucella spp. infection or seropositivity in humans.
Quality assessment and data extraction
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Animal species involved,
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Brucella species or their biovars identified,
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Relative risk and odds ratio estimates of the strength of association between Brucella seropositivity in humans and potential risk factors,
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Disease prevention or control methods used,
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Type of study,
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Study outcome and reviewer comments,
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Location of study,
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Study population,
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Study period,
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Sampling approach (probability or nonprobability sampling),
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Diagnostic test used,
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Sampling strategy,
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Bias and/or gaps in sampling method described.
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The sampling strategy for animals was categorized into herd, flock, individual, abattoir, meat market, and milk markets. For the farm studies, the livestock production system was identified and where multiple surveys were reported in a single study, each survey was listed separately.
Results
Data acquisition
Evolution and spatial distribution of publications
Human brucellosis
Population | County | Diagnostic test | Complementary tests | Study outcome | Ref | |
---|---|---|---|---|---|---|
Diseases frequencya | Risk factor | |||||
Apparently healthy | National | ELISA | NA |
3 (1.0–5.0)
| Yes | [24] |
Nairobi Central Coast Eastern N/eastern Nyanza Rift Valley Western | NA |
0
1.1 (0.0–2.7)
1.0 (0.0–2.9)
1.5 (0.0–4.3)
10.3 (0.0–21.8)
0
2.8 (0.0–7.0)
0.5 (0.0–1.6)
| ||||
Apparently healthy | Kiambu Kajiado Marsabit | ELISA | NA |
2.4 (1.9–30)
15.3 (10.5–21.8)
46.5 (39.0–54.1)
| Yes | [32] |
Outbreak patients | Garissa | RBT/BMAT | ELISA,CFT | 5 of 12 outbreak cases | No | [17] |
Hospital patients | Narok | RBT | NA | 21.2 (13.8–35.9) | No | [23] |
Hospital patients | Machakos | RBT | SAT | 39 patients case series report | No | [25] |
Hospital patients | Machakos | RBT | CFT,SAT |
10.4
b
| No | [26] |
Hospital patients | Garissa | RBT | PCR |
31.8
b
| Yes | [21] |
High risk pastoralist population | Isiolo | QS | NA | QS | Yes | [33] |
Hospital patients | Nairobi | RBT | ELISA |
5 (1.4–9.4)
| No | [22] |
Hospital patients | Nairobi | ELISA | Isolation | 2 BM isolates and 21 seropositive from study cohort | No | [27] |
High risk pastoralist population | Turkana | RBT | ELISA |
17 (13.1–22.4)
| Yes | [30] |
Hospital patients | NS | RBT | Isolation | 70 isolates (64BM,6BA) from case reports | No | [29] |
Hospital patients | NS | Isolation | NA | 1 BA isolate from a case report | No | [19] |
Hospital patients | Kiambu Narok | RBT/SAT | IFA |
3.2 (1.1–4.5)
14.4 (8.0–18.9)
| No | [31] |
High risk occupational groups | Nairobi Naivasha | SAT | NA |
2 (0.5–4.5)
7 (4.1–14.6)
| No | [20] |
High risk pastoralist population | Marsabit | QS | NA | QS | Yes | [34] |
High risk occupational groups | Busia | RBT | NA |
0.1 (0.007–0.8)
| No | [18] |
Hospital patients | Busia | RBT | BPAT, Coombs, SAT |
0.6 (0.04–0.9)
| NO | [28] |
Animal brucellosis
Population production system | Test (No. of studies)a | % Range of seroprevalenceb | Reference | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Camel | Cattle | Sheep | Goat | Milk | Pigs | Wildlife | Camel | Cattle | Sheep | Goat | Milk | Pig | Wild life | ||
Pastoral | E(1), R(3),S(1), C(1) | E(3), R(3),S(3), C(2) | E(1) | E(2) R(1) | S(1), C(1) | 10.3–38.0 | 9.9–16.9 | 11.9 | 13–16.1 | 18–30 | |||||
Agro-pastoralist | - | E(1), R(1), S(1) | E(1), R(1) | E(2), R(1) | E(1), M(1) | - | 3.3-10.0 | 0–3.4 | 3.6–5.0 | ||||||
Small holder | - | E(2), S(1) | E(1) | E(1), R(1) | M(3) E(2) | - | - | 0.8-9.0 | 2.4 | 0–1.3 | 0–13.6 | ||||
Abattoir | R(1) S(1), C(1) | 0.2 | [47] | ||||||||||||
Extensive | R(1), S(1) C(1) | R(2), S(1), C(1) | R(1) S(1) C(1) | R(1) S(1), C(1) | R(1), S(1), C(1) | 8 | 17& 7/10 cases | 0 | 0 | - | - | 0-14 | |||
Not specified | I(1) | M(1) E(1) | I(1) | 0–10 |
Risk factors associated with human brucellosis
County | Study population characteristics | Variable | Risk factors | (aOR, 95 % CI)a | Ref |
---|---|---|---|---|---|
Marsabit | Pastoral | Individual | Age by decade Male sex Use of milk from own animals Assist in animal delivery Exposure to sheep Exposure to goats Handling of animal hides | 1.1 (1.0–1.2 3.0 (2.2–4.0) 3.2 (1.7–5.8) 1.6 (1.1–2.3) 2.0 (1.4–2.8 2.1 (1.4–3.2) 1.4 (1.1–1.8) | [32] |
Household | Pastoral production system Nomadic movements Male household head Keeping sheep | 42.7 (21.1–86.5) 5.7 (4.2–7.7) 2.5 (2.0–3.0) 4.0 (1.7–9.3) | |||
Kiambu | Small holder | Individual | Age by decade Handling of animal hides Higher education | 1.6 (1.5–1.6) 83.2 (24.9–278.7) 0.1 (0.0–0.5) | |
Household | Male household head Sold livestock (1 year ago) Keeping sheep | 3.0 (2.0–4.7) 2.1 (1.4–3.3) 3.5 (1.2–10.5) | |||
Kanjiado | Agro-pastoral | Individual | Age by decade Use of milk from own animals Regular ingestion of raw milk Exposure to sheep Handling of animal hides Higher Education | 1.2 (1.2–1.4) 2.0 (1.4–3.0) 2.7 (1.9–3.9) 3.2 (2.1–5.0) 1.5 (1.2–2.0) 0.7 (0.5–0.9) | |
Household | Pastoral production system Nomadic movements Male household head Use of calving pens No exposure to aborted game | 2.9 (2.1–4.0) 2.3 (1.7–3.2) 4.5 (3.4–5.9) 4.4 (1.6–11.6) 0.5 (0.2–1.2) | |||
National | Diverse | Individual | No education Male Advanced age (50+ years) | 7.29 (1.48–35.94) 4.67 (2.37–9.19) 3.38 (1.08–10.65) | [24] |
Garissa | Pastoral | Individual | Consumption of raw milk Obtaining milk from informal market | 8.5 (4.20–17.26) 7.3 (2.51–21.10) | [21] |
Isiolo | Pastoral | Household | Drinking raw milk Contact with aborted materials or Help during animal birth | 6.57 (2.92–14.82) 1.42 (0.76–2.64) 1.27 (0.71–2.27) | [33] |
Turkana | Pastoral and small holder | Individual | Pastoral production system Drinking raw blood Animal slaughter Communal grazing (exposure to goats) Communal grazing (exposure to cattle) | 1.8 (p = 0.007) 1.4 (p = 0.025) 1.9 (p < 0.001) 1.6 (p = 0.003) 2.8 (p < 0.001) | [30]b |
Marsabit | Pastoral | Household | Women Drinking of raw blood Consumption of raw milk Household milk harvesting | 1.62 (p < 0.001) 1.64 (p < 0.001) 1.64 (p = 0.001) 3.87 (p < 0.001) | [34]b |