Epidemiology of bovine brucellosis in Hisar, India: identification of risk factors and assessment of knowledge, attitudes, and practices among livestock owners.

Brucellosis caused by facultative intracellular bacteria, Brucella, remains a global threat to both animal and human health. In this study we aimed to identify potential risk factors of bovine brucellosis and to assess the knowledge, attitudes, and practices (KAPs) of livestock keepers in Hisar, India. A standardized questionnaire was used to collate information regarding potential risk factors of bovine brucellosis and livestock owners' KAPs. A total of 127 livestock keepers were involved. Serum samples from their animals (n = 635) were tested for the presence of antibodies against Brucella by Rose Bengal Plate Test (RBPT) and indirect enzyme-linked immunosorbent assay (iELISA). Out of these, 78 (61.4%) of the herds had at least one seropositive animal, and 302 (47.6%) of the cattle were seropositive. Univariate and multivariate analysis revealed significant associations between intensive farm type (OR = 4.6; 95% CI, 1.6-16.7; P = 0.009), hygienic disposal of aborted fetuses (OR = 0.3; 95% CI, 0.08-0.9; P = 0.04) and herd seropositivity for brucellosis. The majority, 96 (75.6%) of the respondents, were males aged 18-50, and 82 (64.6%) owned a small-backyard farm. Only 51 (40.2%) of the participants knew about brucellosis; out of them, 54.9% (28/51) could not identify clinical signs of brucellosis. Six (11.8%) participants indicated abortion as the most noticeable clinical sign, and 45.1% indicated that consumption of raw milk is associated with high risk of contracting brucellosis. A large proportion of respondents confirmed that milk from their animals was regularly consumed (86.6%) and sold (59.8%) to other people. These results suggest that bovine brucellosis is endemic in Haryana, where Brucella-contaminated milk is likely being regularly sold. Brucellosis control efforts in Haryana should include education programs to raise awareness of the disease and means to control it in cattle and to prevent zoonotic transmission.

Systematic review of brucellosis in the Middle East: disease frequency in ruminants and humans and risk factors for human infection.

A systematic review of studies providing frequency estimates of brucellosis in humans and ruminants and risk factors for Brucella spp. seropositivity in humans in the Middle East was conducted to collate current knowledge of brucellosis in this region. Eight databases were searched for peer-reviewed original Arabic, English, French and Persian journal articles; the search was conducted on June 2014. Two reviewers evaluated articles for inclusion based on pre-defined criteria. Of 451 research articles, only 87 articles passed the screening process and provided bacteriological and serological evidence for brucellosis in all Middle Eastern countries. Brucella melitensis and B. abortus have been identified in most countries in the Middle East, supporting the notion of widespread presence of Brucella spp. especially B. melitensis across the region. Of the 87 articles, 49 were used to provide evidence of the presence of Brucella spp. but only 11 provided new knowledge on the frequency of brucellosis in humans and ruminants or on human risk factors for seropositivity and were deemed of sufficient quality. Small ruminant populations in the region show seroprevalence values that are among the highest worldwide. Human cases are likely to arise from subpopulations occupationally exposed to ruminants or from the consumption of unpasteurized dairy products. The Middle East is in need of well-designed observational studies that could generate reliable frequency estimates needed to assess the burden of disease and to inform disease control policies.

Brucellosis in West and Central Africa: A review of the current situation in a changing landscape of dairy cattle systems.

Brucellosis is a neglected endemic zoonosis in West and Central Africa. In this narrative review, evidence of livestock and human infection is presented along with details of past and current control strategies in 14 selected countries. Data from available literature is combined with expert opinion elicited during a regional workshop on brucellosis diagnostics. Demographic changes that affect both the epidemiology of brucellosis and the success of control or surveillance are also considered. The evidence suggests that brucellosis prevalence in emerging peri-urban dairy cattle systems may be higher than that found in traditional transhumant extensive systems. Accurate microbiological and epidemiological evidence across the region is lacking but it appears there is inherent interest in controlling the disease. There are many data gaps which require collaborative future research to evaluate fully the social and economic impact of the disease in an evolving livestock sector heavily influenced by high rates of urbanisation and regional population growth.

Cross-sectional study of brucellosis in Jordan: Prevalence, risk factors and spatial distribution in small ruminants and cattle.

Brucellosis is considered endemic in many Middle Eastern countries including Jordan. To determine the frequency, risk factors and spatial distribution of ruminant brucellosis in Jordan, a nationwide cross-sectional study was conducted. Small ruminant flocks (n=333) and cattle herds (n=204) were randomly selected, and their disease status was ascertained by testing individual serum samples using the Rose Bengal Test and a competitive ELISA (sheep and goats) and milk samples using an indirect ELISA (cattle). Information on putative risk factors was collected using standardized questionnaires. A logistic model with a binomial outcome was built to identify risk factors for being seropositive. The estimated true seroprevalence values were 18.1% (95% CI: 11-25.3) (cattle-only herds), 22.2% (95% CI: 16.5-28.8) (sheep flocks), 45.4% (95% CI: 30.3-61.6) (goat herds), 70.4% (95% CI: 55.5-84.9) (mixed sheep-goat flocks), 34.3% (95% CI: 28.4, 40.4) (all small ruminant flocks) and 38.5% (95% CI: 24.3-51.8) (mixed herds of cattle and small ruminants). Only 1.5% of small ruminant flocks were vaccinated. The seroprevalence was higher in northern areas, where livestock density is also higher. The logistic model fitted the data well and had a very high predictive ability. In the small ruminant model, five variables were significantly associated with a higher odds of seropositivity: lending/borrowing rams (OR=8.9, 95% CI: 3.0-26.1), feeding aborted material to dogs (OR=8.0, 95% CI: 3.5-18.1) the presence of goats (OR=6.9, 95% CI: 3.1-15.4), introducing new animals to the flock (OR=5.8, 95% CI: 2.5-13.6), and a large flock size (OR=2.2, 95% CI: 1.0-4.6). Conversely, separating newly introduced animals (OR=0.16, 95% CI: 0.05-0.47), separating animals that had aborted (OR=0.19, 95% CI: 0.08-0.46) and using disinfectants to clean pens (OR=0.37, 95% CI: 0.16-0.83) were significantly associated with a lower odds of being seropositive. The main risk factor for cattle herds being seropositive was the introduction of new animals (OR=11.7, 95% CI: 2.8-49.4); while separation of newly introduced animals (OR=0.09, 95% CI: 0.03-0.29), herd disinfection (OR=0.04, 95% CI: 0.01-0.15) and having calving pens (OR=0.14, 95% CI: 0.05-0.43) significantly reduced the odds of infection. Brucellosis is endemic at high levels across Jordan, and the current vaccination programme, which is limited to small ruminants, has very low coverage. A revised brucellosis control programme is required in Jordan. Given the high baseline prevalence, it should be based on vaccination accompanied by measures to promote hygiene and husbandry practices that minimize the risk of introduction and maintenance of Brucella spp., and thereby the risk of human infection.

Hydroxypropyl methylcellulose in extracapsular cataract surgery with intraocular lens implantation: intraocular pressure and inflammatory response.

We studied prospectively the effects of 2% hydroxypropylmethylcellulose (HPMC), instilled in to the anterior chamber during extracapsular cataract extraction with posterior chamber intraocular lens implantation in 122 patients. Significant pressure rise was noted at 12 and 24 hours post-operatively when HPMC was not removed at the end of surgery. This was prevented by washing HPMC from the anterior chamber at the end of surgery, or by using either acetazolamide or a combination of oxyphenbutazone and vitamin C without washing HPMC. There was no difference in intraocular inflammation between controls and the HPMC groups. The group receiving combined oxyphenbutazone and vitamin C had the least, the differences between these two groups being sufficient.