Human Brucellosis in Tuzla Canton - Zdravlje, medicina, lijecenje, zdravstveni portal

Human Brucellosis in Tuzla Canton

Human Brucellosis in Tuzla Canton
Sead Ahmetagic, Nijaz Tihic, Aldina Ahmetagic, Amer Custovic, Arnela Smriko-Nuhanovic, Nermina Mehinovic, Humera Porobic-Jahic
Med Arh. 2012; 66(5): 309-314

View PDF Fulltext


Introduction: The prevalence of human brucellosis in Bosnia and Herzegovina and the Tuzla Canton reached its peak in 2008, with a reported total of 994 cases within country, and with 104 cases within the Tuzla Canton. Aim: to analyze the clinical and epidemiological features of human brucellosis in patients hospitalized at the University Clinical Center Tuzla during the period from 01/01/2000 till the 31/12/2010. Methods: We retrospectively analyzed the clinical symptoms, the laboratory and X-ray findings, the treatments, and the course and outcome of the disease. The diagnosis of brucellosis was based on anamnesis, clinical presentation, in correlation with a positive blood-culture, and/or serological tests. Results: The majority of patients (93.18%) were from rural regions. There were more males (79.54%) than females. Most of the patients were aged between 30 to 39 years (21% cases). Contact with infected animals was registered for 83.40% of the patients. The main symptoms and signs were fever, joint-pains, night sweating, anorexia, headaches, and hepatosplenomegaly. The important laboratory findings were increased erythrocyte sedimentation rates, increased values of C-reactive protein, and anemia. Adult patients were treated with a combination of gentamicin or streptomycin with doxycycline, and the children with a combination of gentamicin, and trimethoprim-sulfametaxasol, over at least 6 weeks. Complications were documented in 20.45% of the patients. Relapses were observed in 14.20%, and a chronic form of brucellosis in 5.11% of patients. There were no cases with lethal outcomes. Conclusion: Brucellosis is a growing public health problem, not only within the Tuzla Canton, but throughout Bosnia and Herzegovina.


1. Pappas G, Papadimitricu P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006; 6: 91-99.

2. Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis. 2007; 7: 775-786.

3. Pappas G, Akritidis N, Bosilovski M, Tsianos E. Brucellosis. N Engl J Med. 2005; 352: 2325-2336.

4. Dequi S, Donglou X, Jiming Y. Epidemiology and control of brucellosis in China. Vet Microbiol. 2002; 90: 165-182.

5. Bosilovski M, Krteva L, Dimzova M, Kondova I. Brucellosis in 418 patients from the Balkan Peninsula: exposure-related differences in clinical manifestations, laboratory test results, and therapy outcome. Int J Infect Dis. 2007; 11: 342-347.

6. Al-Shamahy HA, Wright SG. A study of 235 cases of human brucellosis in Sana’a, Republic of Yemen, East Mediterr Health J. 2001; 7: 238-246.

7. Lahuerta A, Helwigh B, Mäkelä P. Zoonoses in Europe: distribution and trends–the EFSA–ECDC Community Summary Report 2008. Eurosurveillance. 2010: 47.

8. Taleski V, Zerva L, Kantardijev T, et all. An overview of the epidemiology and epizootiology of the brucellosis in selected countries of Central and Southeast Europe. Vet Microbiol. 2002; 90: 135-145.

9. Nikolovski B. Epidemiologija bruceloze u Republici Makedoniji. ‘’Bruceloza-javnozdravstveni problem’’. U: Knjiga sažetaka–20. simpozijum iz infektivnih bolesti s međunarodnim sudjelovanjem, Sarajevo, 2006: 21.

10. Gaon J. Brucellosis. U: Gaon J, Borjanović S, Vuković B, Turić A, Puvačić Z. Specijalna epidemiologija akutnih zaraznih bolesti. Sarajevo: Svjetlost, 1982: 192-196.

11. Obradović Z, Velić R. Epidemiological Characteristics of Brucellosis in Federation of Bosnia and Herzegovina. Croat Med J. 2010; 51(4): 345-350.

12. Obradović Z, Derviškadić N. Brucellosis in Herzegovina. In: Abstract Book-The First Symposium of zoonoses with international participation. Sarajevo: 2005: 68.

13. Krkić-Dautović S, Mehanić S, Ferhatović M, Čavaljuga S. Brucellosis – epidemiological and clinical aspects (Is brucellosis a major public health problem in Bosnia and Herzegovina?). Bosn J Basic Med Sci. 2006; 6: 11-15.

14. Golubović S, Marić J, Santrač V, Verhaz A, Rodić Ž, Kezić Z, Šego I. Izvještaj o kliničkom i serološkom praćenju bruceloze ljudi od 1984-2005. U: Knjiga sažetaka-Bruceloza javnozdravstveni problem Bosne i Hercegovine i regiona. 20. simpozijum iz infektivnih bolesti s međunarodnim sudjelovanjem. Sarajevo: 2005: 32-33.

15. Ahmetagić S, Topalović B, Mešanović J, Šabović S, Pavić G. Zoonoses in Tuzla Canton always a current problem. In: Abstract Book–The First Symposium of zoonoses with international participation. Sarajevo: 2005; 118.

16. Anonymous. Federalni zavod za javno zdravstvo, Sarajevo.

17. Annonymous. European Food Safety Authority (EFSA), European Centre for Disease Prevention and Control (ECDC). The Community Summary Report on Trends and Sources of Zoonoses and Zoonotic Agents and Foodborne Outbreaks in The European Union in 2008, EFSA Journal; 2010; 8(1): 1496.

18. Mačkić S, Katica V. Bruceloza – raširenost, klinička slika kod domaćih životinja i pojava na području Federacije BiH u periodu od 2000-2005. U: Knjiga sažetaka – Bruceloza javnozdravstveni problem Bosne i Hercegovine i regiona. 20. simpozijum iz infektivnih bolesti s međunarodnim sudjelovanjem. Sarajevo, 2005: 51.

19. Ferizbegović J, Lonić E, Hajdarević E. Pojava i širenje bruceloze kod domaćih životinja na prostoru TK, na bazi provedenih istraživanja po osnovu kantonalnog programa. U: Knjiga sažetaka 22. simpozijuma infektologa BiH s međunarodnim sudjelovanjem. Tuzla: 2008: 200.

20. Conference on Control of Brucellosis in Bosnia and Herzegovina, Teslić, Novembar 5. 2009 – Presentation. Ured za veterinarstvo BiH. Available

21. Jeren T. Brucella species. In: Begovac J, Božinović D, Lisic M, Baršić B, Schönwald S, ur. Infektologija. I. izd. Zagreb: Profil, 2006: 629-631.

22. Ahmetagić S, Piljić D, Smriko-Nuhanović A, Ahmetagić A, Topalović B. Kliničke i epidemiološke karakteristike bruceloze u hospitaliziranih bolesnika. Infektološki glasnik Zagreb, 2008; 28 (3):135-143.

23. Aygen B, Doganay M, Sumerkan B, Yildiz O, Kayaba U. Clinical manifestations, complications and treatment of brucellosis: a retrospective evaluation of 480 patients. Med Mal Infect. 2002; 32: 485-493.

24. Yinnon AM, Morall GA, Goren A, Rudensky B, Isacsohn M, Michel J, et al. Effect of age and duration of disease on the clinical manifestations of brucellosis. A study of 73 consecutive patients in Israel. Isr J Med Sci. 1993; 29: 11-16.

25. Memish Z, Mah MW, Al Mahmoud S, Al Shaalan M, Khan MY. Brucella bacteriaemia: clinical and laboratory observations in 160 patients. J Infect. 2000; 40: 59-63.

26. Andriopulos P, Tsironi M, Deftereos S, Aessopos A, Assimakopoulos G, Acute brucellosis: presentation, diagnosis, and treatment of 144 cases. Int J Infect Dis. 2007; 11: 51-57.

27. Shebabi A, Shakir K, el-Khateeb M, Qubain H, Fararjeh N, Shamat AR. Diagnosis and treatment of 106 cases of human brucellosis. J Infect. 1990; 20: 5-10.

28. Demiroglu YZ, Turunc T, Aliskan H, Colakoglu S, Arslan H. Brucellosis retrospective evaluation of the clinical, laboratory and epidemiological features of 151 cases Mikrobiyol, Bul. 2007; 41: 517-527.

29. Tasbakan MI, Yamazhan T, Gökengin D, Arda B, Sertpolat M, Ulusoy S, et al. Brucellosis: a retrospective evaluation. Trop Doct. 2003; 33: 151-153.

30. Pourbagher MA, Pourbagher A, Savas L, Turunc. T, Demiroglu YZ, Erol I, et al. Clinical pattern and abdominal sonographic findings in 251 cases of brucellosis in southern Turkey. AJR Am J Roentgenol. 2006; 187: W191-4.

31. Trujillo IZ, Zavala AN, Caceres JG, Miranda CQ. Brucellosis. Infect Dis Clin North Am. 1994; 8: 225-241.

32. Bosilkovski M, Krteva Lj, Dimzova M, Vidinić I, Sopova Ž, Spasovska K. Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region. Croat Med J. 2010; 51(4): 327-336.

33. Annonymous. Brucellosis in humans and animals [monograph on the internet]. Geneva: WHO Press; 2006 [cited 2012 Feb 18]. Available from:

34. Lopes LB, Nicolino R, Haddad JPA. Brucellosis – Risk Factors and Prevalence: A Review. The Open Veterinary Science Journal, 2010; 4: 72-84.

35. Čekanac R, Mladenović J, Ristanović E, Lazić S. Epidemiological Characteristics of Brucellosis in Serbia, 1980-2008. Croat Med J. 2010; 51(4): 337-344.

36. Afsharpaiman S, Mamishi S. Brucellosis: Review of clinical and laboratory features and therapeutic regimens in 44 children. Acta Medica Iranica. 2008; 46(6): 489-494.

37. Mehanic S, Mulabdic V, Baljic R, Hadzovic-Cengic M, Pinjo F, Hadziosmanovic V, Topalovic J. Brucella Endocarditis in Prosthetic Valves. Mat Soc Med. 2012 Jun; 24(2, supl 1): 11-12.

Leave a reply

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>