Sero-prevalence of human brucellosis and associated factors among febrile patients attending Moyale Primary Hospital, Southern Ethiopia, 2023: Evidences from pastoralist community

Background: Brucellosis is a neglected zoonotic disease often contracted through contact with animals and consumption of unpasteurized dairy products. Despite being the most common cause of non-malarial acute febrile illness brucellosis is often misdiagnosed in healthcare setups. The global incidence of Brucella infection is reported to be over 2 million cases annually. In Ethiopia, there are varying reports on the prevalence of brucellosis, and just a few researches have been undertaken on the prevalence among febrile patients. Therefore, this study aimed to determine sero-prevalence of human brucellosis and associated factors among febrile patients attending Moyale Primary Hospital in southern Ethiopia. Methods: Cross-sectional study was conducted on 293 febrile patients attending Moyale Primary Hospital. We used convenience sampling technique. Blood specimen was collected and screened for Brucella antibody using Rose-Bengal plate test and ELISA was used for confirmation of Brucella infection. We used a questionnaire to collect socio-demographic data and to assess associated factors (S1 Table). Bivariate and subsequent multivariable logistic regression was performed to explore associated factors with the prevalence of human brucellosis. Results: The sero-prevalence of human brucellosis in this study was 13% (95% CI: 9.5, 16.5). Majority of the study participants (58.7%) were rural dwellers; 54.6% were male and the age range was from 5 to 80 years (mean = 24.17, SD = ±15.9). Higher number of sero-prevalence was seen among rural residents (19.8%) and male participants (14.40%). Drinking unpasteurized camel milk (AOR = 11.62, 95% CI: 3.85, 17.13; P = 0.000) and rural residence (AOR = 7.21, 95% CI: 2.48, 15.90; P = 0.000) were significantly associated with brucellosis. Consumption of pasteurized milk was shown to have protective effect (AOR = 6.12, 95% CI: 1.26, 29.76; P = 0.025) against brucellosis. Conclusion: The current study showed 13% point prevalence of human brucellosis among febrile patients attending Moyale Primary Hospital. Consuming unpasteurized milk, particularly unpasteurized camel milk, and rural residence was significantly associated with Brucella infection. Awareness creation about the zoonotic nature of brucellosis and the role of unpasteurized milk in the transmission of the disease is important to control human brucellosis. Author summary: Brucellosis is a zoonotic bacterial infection that poses significant public health challenges, particularly in pastoralist communities where human-animal interactions are frequent. The disease is often underdiagnosed due to its nonspecific symptoms, which mimic other febrile illnesses, leading to prolonged suffering and potential complications. Understanding the sero-prevalence of human brucellosis and identifying associated risk factors are crucial steps in improving diagnostic strategies and guiding public health interventions. This study focuses on febrile patients attending Moyale Primary Hospital in southern Ethiopia, a region predominantly inhabited by pastoralist communities. By examining the prevalence of brucellosis and exploring the socio-demographic and environmental factors linked to the infection, this research provides valuable insights into the burden of the disease in this vulnerable population. The findings highlight the need for targeted awareness programs, improved diagnostic protocols, and strategic public health measures to mitigate the impact of brucellosis in pastoralist settings.