| ObjectiveTo analyze the epidemiological characteristics of human brucellosis of Tai'an city from 2005 to 2014 and explore the current situation in the most serious epidemic area of Tai'an city,as well as discuss the factors causing the rising incidence of brucellosis.To provide practical basis for developing and improving brucellosis prevention and control strategy in Tai'an city.MethodMaterials of human brucellosis from 2005 to 2014 was downloaded from China Information System for Disease Control and Prevention,and was analyzed in descriptive epidemiological method.A case-control study was conducted based on cases confirmed in2015 and comparable controls to explore the risk factors of brucellosis in Tai'an city overall.A special cross-sectional study was carried out in the most serious village,where human brucellosis prevalence and family information were investigated,to discover the risk factors in the village.Spearman rank correlation,?~2-test and Logistic regression analysis were used to analyze the information,and association strength was showed using odds ratio or relative risk with the confidence interval.Results1.164 cases were reported in Tai'an city between 2005 and 2014,and the annual incidence fluctuated between 0~1.47/100 000,with an average annual incidence of0.30/100 000.There was a rising trend in the incidence in Tai'an city(r_s=0.71,P<0.05),which was more obvious from 2012 to 2014,lagging behind the whole country and Shandong province,and the epidemic areas expanded constantly.More cases occurred in the second and the third quarter.Regional difference existed in the prevalence of brucellosis in Tai'an city.The incidence rate in Daiyue District was highest,and there was statistical significance between different counties(?~2=84.30,P<0.01).To the gender distribution,the incidence of male was significantly higher than that of female(?~2=29.72,P<0.001),and the sex tatio was 2.47.The youngest suffer was 2 years old and the eldest one was 72,and 86.59%of all cases were between 30 to 69 years old.Cases were mainly farmers,accounting for 84.76%of all cases.2.Among the 110 cases confirmed in 2015,81 cases had a history of contact with goats,accounting for 73.64%of all cases.14.55%of cases had a history of contact with cows.Difference of exposure to goats between cases and controls was statistically significant(OR=10.57,95%CI:5.65~19.75),so was to cows(OR=6.07,95%CI:1.72~21.49).As to the exposure mode,65.45%of all cases had a contact history of rearing.18.18%of all cases had a contact history of slaughtering livestock.9.09%of all cases had a contact history of product processing.While in the controls,the ratios of these three kinds of exposure history were 13.64%,8.18%and 0.91%,which were lower than those in cases.Data from multivariate analysis showed that history of rearing,slaughtering livestock and product processing were risk factors.3.A serological survey was carried out in a village,where the brucellosis epidemic was most serious in Tai'an city.9 positive samples were detected among the 309 ones,with a prevalence of 2.91%.Among the 55 samples of people under 29 years old or over 70,no positive was detected,while 9 positive samples was detected out of the 254 people aged from 30 to 69,and No significant difference was found in the detection rate between the two age groups(P=0.33).Positive samples existed in all age groups between 30 and 69years old,and the positive rate fluctuated between 2.22%and 4.35%.4.A total of 112 questionnaires were received from families of the village,among which 31 were from case families and 81 were from control families.The survey results revealed that different chopping boards used to prepare raw or cooked food could lower the risk of brucellosis onset(OR=0.23,95%CI:0.08~0.66),the same to washing hands more than 10 times in a day(OR=0.29,95%CI:0.11~0.80),while raw meat processing was a risk factor(OR=3.28,95%CI:1.25~8.61).Conclusions1.A rising trend could be find in human brucellosis incidence in Tai'an city,especially since 2012,and the epidemic areas expanded constantly.2.The main source of human brucellosis in Tai'an city were goats and cows,and the main risk factors were rearing livestock,slaughtering livestock and product processing,which made a 5~28 times onset risk as the non-exposed group.3.In most serious area of Tai'an city,human brucellosis infection rate has reached up to 2.91%.Results showed that based on family,different chopping boards used to prepare raw or cooked food and washing hands more than 10 times in a day were protective factors,while raw meat processing was a risk factor. |
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