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Open Access Highly Accessed Research article

The changing pattern of human brucellosis: clinical manifestations, epidemiology, and treatment outcomes over three decades in Georgia

Tamar Akhvlediani1*, Danielle V Clark2, Giulen Chubabria3, Otar Zenaishvili3 and Matthew J Hepburn4

Author Affiliations

1 Clinical Research Unit, Technology Management Company, Tbilisi, Georgia

2 Walter Reed Army Institute of Research, Silver Spring, MD, USA

3 Institute of Parasitology and Tropical Medicine, Tbilisi, Georgia

4 United States Army Medical Research Institute of Infectious Diseases, Frederick, MD, USA

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BMC Infectious Diseases 2010, 10:346  doi:10.1186/1471-2334-10-346

Published: 9 December 2010

Abstract

Background

Brucellosis is an endemic infection in Georgia. We conducted a review of patient records with a suspected or confirmed diagnosis of brucellosis over three decades at the central referral hospital for brucellosis cases, the Institute of Parasitology and Tropical Medicine (IPTM) in Tbilisi. The purpose was to describe the demographic profile and clinical characteristics as well as diagnostic and treatment strategies in patients with brucellosis.

Methods

Data were abstracted from randomly selected patient records at the IPTM. In total, 300 records were reviewed from three time periods: 1970-73, 1988-89, and 2004-2008.

Results

The age distribution of patients shifted from a median age of 40 years in the first time period to 20 years in the third time period. Azeri ethnicity was an increasing proportion of the total number of cases. The frequency of relapsed infection was 14.7% (44 cases). A total of 50 patients received vaccine therapy, and although the vaccine produced immune responses, demonstrated by an increase in agglutination titers, it was not associated with improved outcome.

Conclusion

The demographics of brucellosis in Georgia fit a profile of persons that tend sheep. Osteoarticular complications were commonly detected, especially in children. The changing pattern of brucellosis in Georgia suggests clinicians should be updated about different trends in brucellosis in their country.