International Journal of Infectious Diseases and Therapy
Volume 2, Issue 4, December 2017, Pages: 66-71
Received: Apr. 3, 2017;
Accepted: May 20, 2017;
Published: Jul. 14, 2017
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Milena Dimitrova Karcheva, Department of Epidemiology, Parasitology and Tropical Medicine, Medical University, Pleven, Bulgaria
Vanya Atanasova Birdanova, Department of Hygiene, Medical Ecology, Occupational Disease and Disaster Medicine, Medical University, Pleven, Bulgaria
Margarita Lubomirova Alexandrova, Department of Biophysics, Medical University, Pleven, Bulgaria
The aim of this study was to describe trends over time of human brucellosis (HB) based on national surveillance data from 1992 to 2016 in Bulgaria and to assess the factors of its re-emergence after 50 years elimination. Retrospective analytical study was applied and performed descriptive, spatial and time series analyses using national aggregated data for HB incidence from National Center of Infectious and Parasitic Diseases (NCIPD)-Sofia. During the 25-year period, 190 confirmed cases were reported, resulting in annual incidence of 0.10 cases per 100,000 populations. Dynamic model of the epidemic process and risk factor were analyzed. The fitted Autoregressive integrated moving average (ARIMA) model of HB incidence also was selected. There were differentiated two cycles of infection spreading out lasting 12-13 years with two epidemic waves (1996 and 2002). Greater incidence of HB was recorded during the peaks of epidemic waves in the second epidemic cycle – 0.52-0.76/100,000 population. Re-emergence of brucellosis in Bulgaria started from areas bordering endemic countries and gradually extended inland. The geographic location of Bulgaria as external border of European Union (EU) and transit crossroad among Asia, Africa and Europe increases the risk of HB re-emergence to the country. Involvement of all responsible institutions for public healthcare is required.
Milena Dimitrova Karcheva,
Vanya Atanasova Birdanova,
Margarita Lubomirova Alexandrova,
Human Brucellosis - New Public Health Problem in Bulgaria, International Journal of Infectious Diseases and Therapy.
Vol. 2, No. 4,
2017, pp. 66-71.
Iliev B, Mitov G, Radev M. editors. Infectologia. 1st ed. Sofia; 2001 (in Bulgarian).
Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. Vol. 6, No. 2, 2006, pp. 91-99.
Akpinar O. Historical perspective of brucellosis: a microbiological and epidemiological overview. Infez Med. Vol. 24, No. 1, 2016, pp. 77-86.
D'Anastasio R, Staniscia T, Milia ML, Manzoli L, Capasso L. Origin, evolution and paleoepidemiology of brucellosis. Epidemiol Infect. Vol. 139, No. 1, 2011, pp. 149-156.
Russo G, Pasquali P, Nenova R, Alexandrov Ts, Ralchev S, Vullo V, et al. Reemergence of human and animal brucellosis, Bulgaria. Emerg Infect Dis. Vol. 15, No. 2, 2009, pp. 314-316.
European Commission. Commission implementing decision of 8 August 2012 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 27. 9. 2012: L 262.
Ordinance № 21 on the procedures for registration, communication and reporting of communicable diseases, Ministry of Health Bulgaria.
Sato RC. Disease management with ARIMA model in time series. Einstein (Sao Paulo). Vol. 11, No. 1, 2013, pp. 128-131.
Zhang X, Zhang T, Young AA, Li X. Applications and Comparisons of Four Time Series Models in Epidemiological Surveillance Data. PLoS ONE. Vol. 9, No. 2, 2014, e88075.
Box GEP, Jenkins GM., Reinsel GC, Ljung GM. Stochastic models and their Forecasting. In: Time series analysis: forecasting and control. 5thed. New Jersey: John Wiley & Sons, Inc.; 2016.
Tzaneva V, Ivanova S, Georgieva M, Tasheva E. Investigation of the spread of brucellosis among human and animal populations in southeastern Bulgaria, 2007. Euro Surveill. Vol. 14, No. 14, 2009: pii: 19187.
Nenova R, Tomova I, Saparevska R, Kantardjiev T. A new outbreak of brucellosis in Bulgaria detected in July 2015-preliminary report. Euro Surveill. 2015; 20 (39): pii = 30031.
Bosilkovski M, Krteva L, Dimzova M, Vidinic I, Sopova Zaklina, Spasovska K. Human Brucellosis in Macedonia – 10 Years of Clinical Experience in Endemic Region. Croat Med J. Vol. 51, No. 4, 2010, pp. 327–336.
Lytras T, Danis K, Dounias G. Incidence Patterns and Occupational Risk Factors of Human Brucellosis in Greece, 2004-2015. Int J Occup Environ Med. Vol. 7, No. 7, 2016, pp. 221-226.
Al Shehhi N, Aziz F, Al Hosani F, Aden B, Blair I. Human brucellosis in the Emirate of Abu Dhabi, United Arab Emirates, 2010-2015. BMC Inf Dis. 2016, pp. 16.
Moosazadeh M, Nikaeen R, Abedi G, Kheradmand M, Safiri S. Epidemiological and Clinical Features of People with Malta Fever in Iran: A Systematic Review and Meta-Analysis. Osong Public Health Res Perspect. Vol. 7, No. 3, 2016, pp. 157-167.
Njeru J, Wareth G, Melzer F, Henning K, Pletz MW, Heller R, et al. Systematic review of brucellosis in Kenya: disease frequency in humans and animals and risk factors for human infection. BMC Public Health. Vol. 16, No. 1, 2016, pp. 853.
Parham PE, Waldock J, Christophides GK, Hemming D, Agusto F, Evans KJ. Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission. Philos Trans R Soc Lond B Biol Sci. Vol. 370, No. 1665, 2016, pii: 20130551.
Mailles A, Garin-Bastuji B, Lavigne JP, Jay M, Sotto A, Maurin M, et al. Human brucellosis in France in the 21st century: Results from national surveillance 2004-2013. Med Mal Infect. 2016; 46 (8): 411-418.