Field Epidemiological Investigation
A retrospective study of clinical diagnosis of brucellosis patients in Suide County of Shaanxi Province in 2015
Shu Wang, Yi Zhang, Suoping Fan, Wenwu Yin, Zhicheng Zhang, Lei Cao, Sa Chen, Weihua Wang, Shaoqi Ning, Yangxin Sun
Published 2018-01-20
Cite as Chin J Endemiol, 2018, 37(1): 64-68. DOI: 10.3760/cma.j.issn.2095-4255.2018.01.014
Abstract
ObjectiveTo learn the diagnosis and treatment of brucellosis patients in Suide County of Shaanxi Province in 2015, and to provide a scientific basis for making accurate prevention and control measures.
MethodsAll the cases diagnosed as brucellosis in Suide County from January 1 to December 31 in 2015 and lived in this county were retrospectively investigated by case questionnaire survey, including basic information, medical procedures, and epidemiological contacts. Descriptive statistical analysis was performed using SPSS 18.0 software.
ResultsIn 2015, 75 cases of brucellosis were diagnosed in Suide County, 75 questionnaires were distributed, with 53 completed questionnaires returned. The average age of respondents was (49 ± 14) years old, of which 84.9% (45/53) were male and 94.3% (50/53) were farmers, except one case was actively monitored by Suide County Centre for Disease Control and Prevention then treated, the rest of the patients were treated after the onset of the disease. Of the 52 patients, one patient was diagnosed after one visit, accounting for 25.0% (13/52); one patient was diagnosed after at least 4 visits, accounting for 3.8% (2/52). The cumulative diagnosis rate at provincial-level hospitals was 1/3 and that at disease prevention and control institutions was 92.7% (51/55), there were no confirmed cases in municipalhospitals, county hospitals, township hospitals, village clinics and individual clinics. For the first reason to see a doctor, 65.4% (34/52) of the patients were fever or accompanied by sweating, fatigue, arthralgia and waist and leg pain. The medians from onset to treatment between the first diagnosis, and 2, 3, 4 visits were 15, 18, 27, 45 days, respectively; the median from onset to diagnosis was 21 days, ranging from 2 to 182 days. Totally 84.9% (45/53) patients had a history of exposure to animals, of which 97.8% (44/45) had contacted the sheep.
ConclusionsThe cases in Suide County are mainly adult male farmers, and the diagnosis rate at hospitals below municipal level is low. It is recommended to strengthen the health intervention of high-risk groups and improve the level of diagnosis and treatment of primary medical staff.
Key words:
Brucellosis; Retrospective studies; Diagnostic errors
Contributor Information
Shu Wang
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Yi Zhang
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Suoping Fan
Institute for Disinfection and Vector Biological Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Wenwu Yin
Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhicheng Zhang
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Lei Cao
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Sa Chen
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Weihua Wang
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Shaoqi Ning
Institute for Infectious Disease Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China
Yangxin Sun
Institute for Disinfection and Vector Biological Control, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, China