Epidemiology, clinical manifestations, laboratory findings and outcome of brucellosis in hospitalized children in Northwest of Iran

Document Type: Original Article


1 Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.


Introduction: Brucellosis is a zoonotic disease, which is associated with great economic and general health concerns. This is an endemic disease in Iran, and thus this study aimed to investigate its epidemiology and trend over a ten-year period in children hospitalized in northwest Iran
Material and Methods: A retrospective study was conducted on children hospitalized with brucellosis diagnosis in the Children's Hospital. Information of the patients, such as type of living place, age, history of consuming unpasteurized dairy products, family history of brucellosis in the past year, type of contact patterns with livestock, clinical symptoms, Wright's test, 2-mercaptoethanol test, Coombs Wright test and treatment failure, was collected
Results: Over a ten-year period, 59 medical records were extracted, out of which 21 subjects (35.6%) were female and 38 (64.4%) male. The mean age of involvement was 80.5 months. In addition, 16.9% and 22% of patients had a history of contact with livestock, and 22% had a history of consuming unpasteurized dairy products. Moreover, 78.6% of patients had Wright’s test titers of ≥1:160 and 91.8% had Coombs test titers of ≥1:160. Blood culture results of 19 patients were available, out of which 21.1% were culture-positive
Conclusion: Epidemiological studies assessing important risk factors for the spread of brucellosis in different regions across the world are very effective in disease control. Moreover, the results revealed that the serological tests can be used to diagnose brucellosis. To the best of our knowledge, this is the first report about epidemiology of children brucellosis in northwest Iran.


1- Donev D, Karadzovski Z, Kasapinov B, Lazarevik V. Epidemiological and public health aspects of brucellosis in the Republic of Macedonia. Prilozi. 2010; 31(1):33-54.  
2- Sofian M, Aghakhani A, Velayati AA, Banifazl M, Eslamifar A, Ramezani A. Risk factors for human brucellosis in Iran: a case-control study. Int J Infect Dis. 2008; 12(2):157-61. 
3- Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005; 352(22):2325-36. 
4- Minas M, Minas A, Gourgulianis K, Stournara A. Epidemiological and clinical aspects of human brucellosis in Central Greece. Jpn J Infect Dis. 2007; 60(6):362-6 
5- Young EJ. An overview of human brucellosis.Clin Infect Dis. 1995; 21(2):283-9. 
6- Feiz J, Sabbaghian H, Mirali M. Brucellosis due to B. melitensis in children: clinical and epidemiologic observations on 95 patients studied in central Iran. Clin Pediatr. 1978;17(12):904-8 
7- Hall WH. Brucellosis. In: Evants AS, Brachman PS, editors. Human bacterial infections. 2nd ed.New York: Plenum Medical Book Co; 1991. P.133-49.
8- Aloufi AD, Memish ZA, Assiri AM, McNabb SJ.Trends of reported human cases of brucellosis, Kingdom of Saudi Arabia, 20042012.J Epidemiol Glob Health.2016;6(1):118.
9- Kassiri H, Amani H, Lotfi M. Epidemiological, laboratory, diagnostic and public health aspects of human brucellosisin western Iran. Asian Pac J Trop Biomed. 2013; 3(8):589-94. 
10- Mantur BG, Biradar MS, Bidri RC, Mulimani MS, Veerappa, Kariholu P, et al. Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years’ experience in an endemic area. J Med
Microbiol. 2006; 55(7):897-903. 
11- Bosilkovski M, Krteva L, Dimzova M, Vidinic I,Sopova Z, Spasovska K. Human brucellosis in Macedonia e 10 years of clinical experience in endemic region. Croat Med J. 2010;51(4):327-36.  
12- Kassiri H, Amani H, Lotfi M, Hosseini S.Epidemiological aspects of human brucellosis in Azna County, Lorestan Province, West of Iran (2007-2008). Jundishapur J Health Res.2011; 1(2):1-9. 
13- Ayazi P, Mahyar A, Rasoli A. Brucellosis in children. J Comprehens Pediatr. 2012;3(1):12-5.  
14- Ayazi P, Rasoli A. Epidemiological, clinical and laboratory features of brucellosis: a retrospective evaluation of 175 children. J Compr Pediatr. 2007; 1(2):31-6. 
15- Otlu S, Sahin M, Ataby HI, Unver A. Serological investigations of brucellosis in cattle, farmers and veterinarians in the Kars district of Turkey. Acta Vet Brno. 2008; 77(1):117-21. 
16- Al-Freihi HM, Al Mohaya SA, Al Mohsen MF, Ibrahim EM, Al-Sohaibani M, Twum Danso K,et al. Brucellosis in Saudi Arabia: diverse manifestations of an important cause of pyrexial illness. Ann Saudi Med. 1986; 6:95-7.  
17- Rubach MP, Halliday JE, Cleaveland S, Crump JA. Crump Brucellosis in low-income and middle-income countries. Curr Opin Infect Dis. 2013; 26(5): 404-12. 
18- Zeinalian Dastjerdi M, Fadaei Nobari R,Ramazanpour J. Epidemiological features of human brucellosis in central Iran, 2006-2011.Public Health. 2012; 126(12):1058-62. 
19- Zeainali M, Shirzadi M, Hajrasouliha H.National manual for brucellosis control.Tehran: Raz Nahan; 2013.
20- Mantur BG, Amarnath SK, Shinde RS. Review of clinical and laboratory features of human brucellosis. Indian J Med Microbiol. 2007;25(3):188-202.  
21- Fiori PL, Mastrandrea S, Rappelli P, Cappuccinelli P. Brucella abortus infection acquired in microbiology laboratories. J ClinMicrobiol. 2000; 38(5):2005-6.
22- Colmenero JD, Reguera JM, Martos F, Sánchez-De-Mora D, Delgado M, Causse M, et al.Complications associated with Brucella melitensis infection: a study of 530 cases.Medicine (Baltimore). 1996; 75(4):195-211. 
23- Buzgan T, Karahocagil MK, Irmak H, Baran AI,Karsen H, Evirgen O, et al. Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis. 2010; 14(6):e469-78.  
24- Roushan MR, Amiri MJ. Update on childhood brucellosis. Recent Pat Antiinfect Drug Discov.2013; 8(1):42-6.  
25- Kamal S, Sadat Hashemi SM, Nasaji M, Moshiri E, Shahriyari R, Azizi A. Frequency of reported cases of Brucellosis to province health center from public and private sectors in Semnan 2006- 2007. Koomesh. 2009; 10(2):125-30. 
26- Mostafavi E, Asmand M. Trend of brucellosis in Iran from 1991 to 2008. Iran J Epidemiol.2012; 8(1):94-101. 
27- Çiftdoğan DY, Bayram N, Vardar F. Brucellosis as a cause of fever of unknown origin in children admitted to a tertiary hospital in the Aegean region of Turkey. Vector Borne Zoonotic Dis. 2011; 11(8):1037-40. 
28- Giannakopoulos I, Nikolakopoulou NM,Eliopoulou M, Ellina A, Kolonitsiou F,
Papanastasiou DA. Presentation of childhood brucellosis in Western Greece. Jpn J Infect Dis.2006; 59(3):160-3. 
29- Soufian M. Determination of brucellosis model in Arak in 2005. Arak Med Univ J. 2006;8(4):31-8. 
30- Soleimani G. Evaluation of clinical findings and treatment of childhood Brucellosis in Zahedan. J Compr Pediatr. 2010; 2:53-7. 
31- Mantur BG, Akki AS, Mangalgi SS, Patil SV, Gobbur RH, Peerapur BV. Childhood brucellosis-a microbiological, epidemiological and clinical study. J Trop Pediatr. 2004;50(3):153-7. 
32- Abdinia B, Barzegar M, Maleki M, Behbod H, Oskoui Sh. Association of Brucella meningoencephalitis with cerebrospinal fluid shunt in a child: a case report. Iran J Child Neurol. 2013; 7(1):35-8.