Hospital-Based Surveillance for Acute Febrile Illness in Egypt: A Focus on Community-Acquired Bloodstream Infections

Background: Our aim was to assess the outcome of pregnancies complicated by Brucella infection. Design: Prospective study. Setting: EL-Hasan National Hospital, El-Rawad Clinic, TAIF, SAUDI ARABIA (where the practical part of the study was accomplished) and Obstetrics & Gynecology Department, Mansoura University Hospital (where the theoretical part of the study was completed). Methods: This study was conducted from August 2005 to December 2007. Tube method for detection of antibody titre for brucellosis was performed on 450 pregnant women; 415 had no symptoms or signs of brucellosis and 35 had symptoms and signs of the disease.The antibody titre was positive in 55 pregnant women (group 1) and negative in 395 pregnant women (group 2). Both groups were followed up during pregnancy and the neonatal period to determine any type of reproductive failure. Results: The incidence of brucellosis was 12 .2 % among pregnant women included in the study. The incidence of abortion in group I was 27.27%; IUFD was 12. 72%; and preterm labour was 10.90%. There were statistically significant differences in the abortion and IUFD rates but no significant difference in the preterm labour rates between the test and control groups. There was a statistically significant difference in abortion rates between patients with a titre more than 1/160 and those with a titre less than 1/160 (p=0.03). Conclusion: The frequency of fetal loss among patients with brucellosis is very high. It is advisable to have a high degree of alertness for brucellosis in endemic areas.

“…This result is in agreement with the study done by Afifi et al [28] in Egypt. However, another study by Sherif et al [31] reported an incidence rate of 3.5% among Egyptian women.…”

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effects of maternal brucellosis on pregnancy outcome

Elshamy

Ahmed²

2008

“…Typhi and Brucella spp were the most common infective agents of acute febrile illness. Particularly S. Typhi was detected in blood samples from 5% of the patients under study [20].…”

Section: Egyptmentioning

confidence: 99%

Enteric Fever in Mediterranean North Africa

Ghenghesh

Franka

Tawil

et al. 2009

Self Cite

Typhoid fever is endemic in the Mediterranean North African countries (Morocco, Algeria, Tunisia, Libya, and Egypt) with an estimated incidence of 10-100 cases per 100,000 persons. Outbreaks caused by Salmonella enterica serovar Typhi are common and mainly due to the consumption of untreated or sewage-contaminated water. Salmonella enterica Paratyphi B is more commonly involved in nosocomial cases of enteric fever in North Africa than expected and leads to high mortality rates among infants with congenital anomalies. Prevalence among travellers returning from this region is low, with an estimate of less than one per 100,000. Although multidrug resistant strains of Salmonella Typhi and Paratyphi are prevalent in this region, the re-emergence of chloramphenicol-and ampicillin-susceptible strains has been observed. In order to better understand the epidemiology of enteric fever in the Mediterranean North African region, population-based studies are needed. These will assist the health authorities in the region in preventing and controlling this important disease.

“…A cross sectional comparative study performed in Egypt detected marked discrepancies among antigens from four different locally available sources at three different cut-off values, when sensitivity and specificity were compared [69]. These discrepancies among different brands were supported by different studies [70,71]. In addition, a semi-quantitative slide agglutination and single-tube Widal test was performed poorly in two sub-Saharan African cites [29].…”

Section: Limitations Of Widal Testmentioning

confidence: 99%

Typhoid fever: misuse of Widal test in Libya

Zorgani

Ziglam

2014

The worldwide gold standard of diagnosing of enteric fever depends on the isolation of Salmonella enterica serovar Typhi from a patient's bone marrow and/or blood culture. In Libya clinicians are heavily dependent on the Widal test for diagnosis of enteric fever which has been used without determining the locally appropriate threshold titer, because the laboratories lack the skilled, experienced personnel and appropriate facilities to detect and serotype Salmonella isolates. To improve the diagnosis process, clinical management and reliability of public health measures, there is an urgent need for the effective training of laboratory technicians and to provide resources to culture Salmonella species according to published guidelines. Clinicians should understand the limitations of Widal test and recognize that it cannot be expected to give a reliable diagnosis.