Exploring the status of brucellosis in pregnant women presented with febrile illness at different healthcare facilities of Vehari and Lodhran zones of Pakistan

BACKGROUND: Brucellosis is an important zoonotic disease which causes stillbirth and abortion in pregnant women. It remains undiagnosed due to nonspecific symptoms like febrility, a very common ailment sign. Accordingly, this study was conducted to determine the seroprevalence and risk-determinants of brucellosis among pregnant women presented with febrile condition to healthcare facilities of Vehari and Lodhran regions of southern Punjab-Pakistan. METHODS: For this cross-sectional study, a total of 250 pregnant women with febrile condition were approached. Of these, 200 willing women were included in this study. Blood samples of participants were analyzed for sero-detection of brucellosis using serum agglutination test (SAT) and commercially available indirect-ELISA kits (sensitivity and specificity>95%) followed by detection of Brucella (B.) species using PCR. Univariate and multivariate analyses were employed to determine the risk factors associated with brucellosis. RESULTS: Overall seropositivity rate of brucellosis by SAT in study population was 18% whereas ELISA revealed the seroprevalence rate of 12% (n = 24/200). PCR findings showed the presence of B. abortus and B. melitensis in seropositive participants. Analysis revealed that nutritional status (P = 0.037, OR=0.2431), educational status (P = 0.049, OR=0.2168), contact with Brucella-susceptible animals (P = 0.009, OR=10.5142), abortion history (P = 0.012, OR=8.7308), raw milk's consumption (P = 0.002, OR=37.1499) and lack of disease awareness (P < 0.001, OR=0.0340) were significantly associated risk factors with brucellosis. Data regarding clinical manifestations revealed the highest frequency (87.50%) of fatigue with general weakness and the lowest one of night sweats (20.83%) in seropositive women. CONCLUSIONS: Brucellosis is prevalent in febrile pregnant women of study area. It is suggested to devise disease control/prevention measures which may include but not limited to enhancing awareness about disease-dynamics, improving disease diagnostic facilities and immunization of susceptible animals from where disease originate.