Seroprevalence of brucellosis in humans, knowledge and practices among patients and medical practitioners in Wakiso District, Uganda

Abstract

Brucellosis is an endemic zoonotic disease of public health and veterinary importance with significant economic losses such as therapy costs, lost income due to time lost by patients away from daily activities and reduced livestock productivity. This study aimed to determine the seroprevalence and level of knowledge of patients about human brucellosis, and assess knowledge and treatment practices of medical practitioners regarding human brucellosis. A cross-sectional study was conducted using a questionnaire and key informant guide among 300 patients and 30 medical practitioners respectively between May2019and July 2019, and retrospectively reviewed medical records of patients diagnosed and treated for brucellosis during the past5years(2014-2018) at Zia Angelina H/CIII, Wakiso district, Central Uganda. Serum samples were tested for Brucella antibodies using Rose Bengal Plate Test. Associations between study participants’ demographics and knowledge were analysed using Chi-square and Fisher's exact tests. Bivariate and multivariate logistic regression analysis were performed to measure the strength of association between the dependent and independent variables of medical practitioners using odds ratios at95% confidence intervals. Variables with a p-value <0.05 were considered statistically significant. The seroprevalence of human brucellosis was 0.3%. Only 6.3% and 26.7% of patients and medical practitioners were knowledgeable about human brucellosis respectively. Patient’s level of knowledge was significantly associated with their age, education level and marital status whereas education level was significantly associated with medical practitioner’s knowledge. On the other hand, 26.7% of medical practitioners reported good practice in management of brucellosis. A multivariate analysis highlighted that knowledge of medical practitioners had a significant effect on their practice, [OR=0.03, 95% CI:0.00-0.29, P=0.002]. According to the review, out of the 42 patients treated for brucellosis, only 26.2% were treated as recommended in the national clinical guidelines. The prevalence of human brucellosis was very low, and patients had poor knowledge about the disease but the study could not determine whether patient’s knowledge influenced disease outcome. Medical practitioners were inadequately knowledgeable and showed poor practices regarding human brucellosis. This suggests a need for health education and capacity building among medical practitioners.