{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:23:23Z","timestamp":1792038203007,"version":"4.4.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009049","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000}}],"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"Defense Threat Reduction Agency of the U.S. Department of Defense"},{"DOI":"10.13039\/100000030","name":"U. S. Centers for Disease Control and Prevention","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Brucellosis occurs globally with highly variable incidence in humans from very low in North America and Western Europe to high in the Middle East and Asia. There are few data in Sub-Saharan Africa. This study estimated the incidence of human brucellosis in a pastoralist community in Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Between February 2015 and January 2016, we enrolled persons living in randomly selected households in Kajiado County. Free health care was offered at three facilities in the study area. Those who met the study clinical case definition completed a standardized questionnaire on demographics, clinical history and presentation. A blood sample was collected and tested by Rose Bengal test (RBT), then later tested at the Kenya Medical Research Institute laboratory for\n                      <jats:italic>Brucella<\/jats:italic>\n                      IgG and IgM by ELISA. Those who tested positive by both RBT and ELISA (IgG or IgM antibodies) were classified as confirmed while those that only tested positive for IgG or IgM antibodies were classified as probable. Further, sera were tested by polymerase chain reaction using a TaqMan Array Card (TAC) for a panel of pathogens causing AFI including\n                      <jats:italic>Brucella spp<\/jats:italic>\n                      . Annual incidence of brucellosis was calculated as the number of confirmed cases in one year\/total number in the study population.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled a cohort of 4746 persons in 804 households. Over half (52.3%) were males and the median age was 18 years (Interquartile range (IQR) 9 months\u2013 32 years). A total of 236 patients were enrolled at three health facilities; 64% were females and the median age was 40.5 years (IQR 28\u201353 years). Thirty-nine (16.5%) were positive for\n                      <jats:italic>Brucella<\/jats:italic>\n                      antibodies by IgG ELISA, 5\/236 (2.1%) by IgM ELISA and 4\/236 (1.7%) by RBT. Ten percent (22\/217) were positive by TAC. We confirmed four (1.7%) brucellosis cases giving an annual incidence of 84\/100,000 persons\/year (95% CI 82, 87). The incidence did not significantly vary by gender, age and location of residence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We report a high incidence of brucellosis in humans among members of this pastoralist community. Brucellosis was the most common cause of febrile illness in this community.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0009049","type":"journal-article","created":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T18:00:47Z","timestamp":1612202447000},"page":"e0009049","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":26,"title":["High incidence of human brucellosis in a rural Pastoralist community in Kenya, 2015"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1950-8616","authenticated-orcid":true,"given":"Peninah","family":"Munyua","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-4279","authenticated-orcid":true,"given":"Eric","family":"Osoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4450-621X","authenticated-orcid":true,"given":"Elizabeth","family":"Hunsperger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6688-3390","authenticated-orcid":true,"given":"Isaac","family":"Ngere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Muturi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athman","family":"Mwatondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9716-6052","authenticated-orcid":true,"given":"Doris","family":"Marwanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Ngere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0742-3279","authenticated-orcid":true,"given":"Rebekah","family":"Tiller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton O.","family":"Onyango","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kariuki","family":"Njenga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0682-6933","authenticated-orcid":true,"given":"Marc-Alain","family":"Widdowson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"issue":"2","key":"pntd.0009049.ref001","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1099\/00222615-46-2-101","article-title":"Recent advances in brucellosis","volume":"46","author":"MJ Corbel","year":"1997","journal-title":"J Med Microbiol"},{"issue":"12","key":"pntd.0009049.ref002","doi-asserted-by":"crossref","first-page":"e1929","DOI":"10.1371\/journal.pntd.0001929","article-title":"Clinical manifestations of human brucellosis: a systematic review and meta-analysis.","volume":"6","author":"AS Dean","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"issue":"2","key":"pntd.0009049.ref003","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/S1473-3099(06)70382-6","article-title":"The new global map of human brucellosis","volume":"6","author":"G Pappas","year":"2006","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"pntd.0009049.ref004","doi-asserted-by":"crossref","first-page":"e1865","DOI":"10.1371\/journal.pntd.0001865","article-title":"Global burden of human brucellosis: a systematic review of disease frequency.","volume":"6","author":"AS Dean","year":"2012","journal-title":"PLoS Negl Trop Dis"},{"issue":"12","key":"pntd.0009049.ref005","doi-asserted-by":"crossref","first-page":"e0167496","DOI":"10.1371\/journal.pone.0167496","article-title":"Epidemiology of Brucellosis and Genetic Diversity of Brucella abortus in Kazakhstan.","volume":"11","author":"E Shevtsova","year":"2016","journal-title":"PLoS One."},{"key":"pntd.0009049.ref006","unstructured":"ECDC. European Centre for Disease Prevention and Control. Brucellosis. In: ECDC. Annual epidemiological report for 2016. Stockholm, August 2018: European Centre for Disease Prevention and Control, 2018 7, March, 2019. Report No."},{"issue":"6","key":"pntd.0009049.ref007","doi-asserted-by":"crossref","first-page":"362","DOI":"10.7883\/yoken.JJID.2007.362","article-title":"Epidemiological and clinical aspects of human brucellosis in Central Greece","volume":"60","author":"M Minas","year":"2007","journal-title":"Jpn J Infect Dis"},{"issue":"3","key":"pntd.0009049.ref008","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1093\/trstmh\/try033","article-title":"Incidence of human brucellosis in the Kilimanjaro Region of Tanzania in the periods 2007\u20132008 and 2012\u20132014","volume":"112","author":"M Carugati","year":"2018","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"7","key":"pntd.0009049.ref009","doi-asserted-by":"crossref","first-page":"e3008","DOI":"10.1371\/journal.pntd.0003008","article-title":"Brucellosis as an emerging threat in developing economies: lessons from Nigeria.","volume":"8","author":"MJ Ducrotoy","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"4","key":"pntd.0009049.ref010","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.prevetmed.2003.08.004","article-title":"Brucellosis and Q-fever seroprevalences of nomadic pastoralists and their livestock in Chad.","volume":"61","author":"E Schelling","year":"2003","journal-title":"Prev Vet Med"},{"issue":"1","key":"pntd.0009049.ref011","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1186\/s12889-016-3532-9","article-title":"Systematic review of brucellosis in Kenya: disease frequency in humans and animals and risk factors for human infection.","volume":"16","author":"J Njeru","year":"2016","journal-title":"BMC Public Health"},{"issue":"2","key":"pntd.0009049.ref012","doi-asserted-by":"crossref","first-page":"224","DOI":"10.4269\/ajtmh.15-0113","article-title":"Strong Association Between Human and Animal Brucella Seropositivity in a Linked Study in Kenya, 2012\u20132013.","volume":"93","author":"EM Osoro","year":"2015","journal-title":"Am J Trop Med Hyg"},{"issue":"1\u20134","key":"pntd.0009049.ref013","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0378-1135(02)00249-3","article-title":"Brucellosis in sub-Saharan Africa: epidemiology, control and impact","volume":"90","author":"JJ McDermott","year":"2002","journal-title":"Vet Microbiol"},{"issue":"5","key":"pntd.0009049.ref014","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1007\/s11250-017-1296-6","article-title":"Incidence and knowledge of bovine brucellosis in Kahuro district, Murang\u2019a County","volume":"49","author":"JN Njuguna","year":"2017","journal-title":"Kenya Trop Anim Health Prod"},{"issue":"12","key":"pntd.0009049.ref015","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.3201\/eid2212.160285","article-title":"Human Brucellosis in Febrile Patients Seeking Treatment at Remote Hospitals, Northeastern Kenya, 2014\u20132015","volume":"22","author":"J Njeru","year":"2016","journal-title":"Emerg Infect Dis"},{"key":"pntd.0009049.ref016","unstructured":"The 2009 Kenya Population and Housing Census volume- 1b Summary Population Distribution By District [Internet]. 2009 [cited March 20, 2019]. Available from: https:\/\/www.opendata.go.ke\/datasets\/summary-population-distribution-by-district\/data."},{"issue":"4","key":"pntd.0009049.ref017","doi-asserted-by":"crossref","first-page":"e950","DOI":"10.1371\/journal.pntd.0000950","article-title":"The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease.","volume":"5","author":"R Diaz","year":"2011","journal-title":"PLoS Negl Trop Dis."},{"issue":"1","key":"pntd.0009049.ref018","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1128\/JCM.02257-15","article-title":"Development of a TaqMan Array Card for Acute-Febrile-Illness Outbreak Investigation and Surveillance of Emerging Pathogens, Including Ebola Virus","volume":"54","author":"J Liu","year":"2016","journal-title":"J Clin Microbiol"},{"issue":"6","key":"pntd.0009049.ref019","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1128\/CVI.00424-07","article-title":"Evaluation of seven tests for diagnosis of human brucellosis in an area where the disease is endemic","volume":"15","author":"MC Gomez","year":"2008","journal-title":"Clin Vaccine Immunol"},{"key":"pntd.0009049.ref020","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.micpath.2019.02.011","article-title":"Clinical and serological approach to patients with brucellosis: A common diagnostic dilemma and a worldwide perspective","volume":"129","author":"M Avijgan","year":"2019","journal-title":"Microb Pathog"},{"issue":"12","key":"pntd.0009049.ref021","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1086\/588482","article-title":"An eternal microbe: Brucella DNA load persists for years after clinical cure","volume":"46","author":"G Vrioni","year":"2008","journal-title":"Clin Infect Dis"},{"key":"pntd.0009049.ref022","volume-title":"WHO Recommended Surveillance Standards.","author":"WHO","edition":"2"},{"issue":"7","key":"pntd.0009049.ref023","doi-asserted-by":"crossref","first-page":"340","DOI":"10.21767\/AMJ.2012.1177","article-title":"A rare case of seronegative culture\u2014proven infection with Brucella suis.","volume":"5","author":"K Naha","year":"2012","journal-title":"Australas Med J."},{"issue":"5","key":"pntd.0009049.ref024","doi-asserted-by":"crossref","first-page":"e005050","DOI":"10.1099\/jmmcr.0.005050","article-title":"An unusual case of seronegative, 16S PCR positive Brucella infection.","volume":"3","author":"B Bharathan","year":"2016","journal-title":"JMM Case Rep"},{"issue":"Pt 7","key":"pntd.0009049.ref025","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1099\/jmm.0.46097-0","article-title":"Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years\u2019 experience in an endemic area","volume":"55","author":"BG Mantur","year":"2006","journal-title":"J Med Microbiol"},{"issue":"3","key":"pntd.0009049.ref026","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1023\/A:1023368420840","article-title":"Epidemiology of human brucellosis in a rural area of north-western Peloponnese in Greece","volume":"18","author":"C Bikas","year":"2003","journal-title":"Eur J Epidemiol"},{"key":"pntd.0009049.ref027","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s40249-015-0072-y","article-title":"Annual trends of human brucellosis in pastoralist communities of south-western Uganda: a retrospective ten-year study.","volume":"4","author":"C Kansiime","year":"2015","journal-title":"Infect Dis Poverty"},{"issue":"1","key":"pntd.0009049.ref028","doi-asserted-by":"crossref","first-page":"43","DOI":"10.4269\/ajtmh.15-0320","article-title":"Serologic Evidence of the Geographic Distribution of Bacterial Zoonotic Agents in Kenya, 2007","volume":"94","author":"VO Omballa","year":"2016","journal-title":"Am J Trop Med Hyg"},{"issue":"12","key":"pntd.0009049.ref029","first-page":"867","article-title":"Human health benefits from livestock vaccination for brucellosis: case study","volume":"81","author":"F Roth","year":"2003","journal-title":"Bull World Health Organ"},{"key":"pntd.0009049.ref030","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.prevetmed.2018.03.023","article-title":"Estimation of the health and economic burden of human brucellosis in India.","volume":"154","author":"BB Singh","year":"2018","journal-title":"Prev Vet Med"},{"issue":"9","key":"pntd.0009049.ref031","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1086\/503035","article-title":"Use of real-time quantitative polymerase chain reaction to monitor the evolution of Brucella melitensis DNA load during therapy and post-therapy follow-up in patients with brucellosis","volume":"42","author":"E Navarro","year":"2006","journal-title":"Clin Infect Dis"},{"issue":"12","key":"pntd.0009049.ref032","doi-asserted-by":"crossref","first-page":"4163","DOI":"10.1128\/JCM.37.12.4163-4166.1999","article-title":"Posttreatment follow-Up of brucellosis by PCR assay","volume":"37","author":"P Morata","year":"1999","journal-title":"J Clin Microbiol"},{"issue":"4","key":"pntd.0009049.ref033","doi-asserted-by":"crossref","first-page":"698","DOI":"10.4269\/ajtmh.2007.76.698","article-title":"Evaluation of brucellosis by PCR and persistence after treatment in patients returning to the hospital for follow-up","volume":"76","author":"KS Maas","year":"2007","journal-title":"Am J Trop Med Hyg"},{"issue":"Pt 5","key":"pntd.0009049.ref034","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1099\/jmm.0.45927-0","article-title":"Diagnosis of human brucellosis caused by Brucella canis","volume":"54","author":"NE Lucero","year":"2005","journal-title":"J Med Microbiol"},{"key":"pntd.0009049.ref035","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0213-005X(01)72547-5","volume":"19","author":"M Ortega","year":"2001","journal-title":"Bacteriemia por Brucella sp. con serolog\u00eda convencional negativa Enfermedades Infecciosas y Microbiolog\u00eda Cl\u00ednica."},{"issue":"1","key":"pntd.0009049.ref036","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12889-017-5016-y","article-title":"Brucellosis remains a neglected disease in the developing world: a call for interdisciplinary action.","volume":"18","author":"KA Franc","year":"2018","journal-title":"BMC Public Health"},{"issue":"5","key":"pntd.0009049.ref037","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1097\/QCO.0b013e3283638104","article-title":"Brucellosis in low-income and middle-income countries.","volume":"26","author":"MP Rubach","year":"2013","journal-title":"Curr Opin Infect Dis"},{"issue":"8","key":"pntd.0009049.ref038","doi-asserted-by":"crossref","first-page":"e0161576","DOI":"10.1371\/journal.pone.0161576","article-title":"Prioritization of Zoonotic Diseases in Kenya, 2015.","volume":"11","author":"P Munyua","year":"2016","journal-title":"PLoS One."},{"issue":"1","key":"pntd.0009049.ref039","doi-asserted-by":"crossref","first-page":"249","DOI":"10.20506\/rst.32.1.2197","article-title":"Economics of brucellosis impact and control in low-income countries","volume":"32","author":"J McDermott","year":"2013","journal-title":"Rev Sci Tech"},{"key":"pntd.0009049.ref040","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1186\/1471-2458-8-241","article-title":"Incidence of human brucellosis in a rural area in Western Greece after the implementation of a vaccination programme against animal brucellosis.","volume":"8","author":"E Jelastopulu","year":"2008","journal-title":"BMC Public Health"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0009049","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009049","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T06:52:23Z","timestamp":1724395943000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009049"}},"subtitle":[],"editor":[{"given":"Christine A.","family":"Petersen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,1]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,1]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0009049","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,1]]}}}