The role of Brucellosis in spontaneous abortion at Narok District Hospital
Background: Brucellosis is a zoonotic infection caused by bacteria of the genus brucella. It is endemic in the Middle East, the Mediterranean and Africa. Brucella is a major aetiological agent of spontaneous abortion in cattle but its role in humans remains controversial. This study was designed to explore the relationship between maternal brucellosis and spontaneous abortion in an endemic area in Kenya. Design: Case control study Setting: This study was based at Narok District Hospital in Narok County. Objectives: 1) To evaluate the serum brucella antibody titres in women presenting with spontaneous abortion compared to women with live deliveries at term. 2) To determine the association between brucellosis and spontaneous abortion in humans. Methods: A total of 324 women were enrolled into the study.82 women with spontaneous abortion were enrolled as cases while 242 with live deliveries after 37 completed weeks of gestation and who in addition had never had an abortion served as the control group. A standard tube agglutination test was performed for estimation of brucella antibody titers. Titers of > 1:160 were considered positive for brucellosis. Results: Out of the 82 cases of spontaneous abortion, 22 had brucella antibody titres 2: 1: 160 while 37 out of a total of the 242 ofthe women in the control group were positive. There was a strong association between brucella antibody titres 2: 1: 160 and spontaneous abortion OR=2.03; 95% C.I (1.114-3.705). Conclusion Women with brucella antibody titres 1:160 are twice at risk of having a spontaneous abortion as compared to those with titres <1:160. Recommendations: In endemic areas educating women of childbearing age on brucellosis prevention may help to prevent the disease and its complications in pregnancy. It is further recommended that testing for human brucellosis should be carried out in at risk women with spontaneous abortion as part of their management. Further studies should be carried out to determine the association between brucella seropositivity and adverse pregnancy outcomes after twenty weeks of gestation.