Int J Health Geogr - Spatial epidemiology of hospital-diagnosed brucellosis in Kampala, Uganda.


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CKGROUND: A retrospective case-control study was undertaken to examine the spatial risk factors for human brucellosis in Kampala, Uganda.METHODS: Information on age, sex and month of diagnosis was derived from records from plate agglutination tests undertaken at Mulago Hospital, Kampala. Information on Parishes (LC2s) where patients reside was sourced from the outpatient registration book. In-patient fracture cases were selected for use as controls using 1:1 matching based on the age, sex and month of diagnosis. The locations of cases and controls were obtained by calculating Cartesian coordinates of the centroids of Parish level (LC2) polygons and a spatial scan statistic was applied to test for disease clustering. Parishes were classified according to the level of urbanization as urban, peri-urban or rural.RESULTS: Significantly more females than males were found to show sero-positivity for brucellosis when compared with the sex ratio of total outpatients, in addition female brucellosis patients were found to be significantly older than the male patients. Spatial clustering of brucellosis cases was observed including around Mulago Hospital (radius = 6.8 km, p = 0.001). The influence of proximity to the hospital that was observed for brucellosis cases was not significantly different from that observed in the controls. The disease cluster was confounded by the different catchment areas between cases and controls. The level of urbanization was not associated with the incidence of brucellosis but living in a slum area was a significant risk factor among urban dwellers (odds ratio 1.97, 95% CI: 1.10-3.61).CONCLUSIONS: Being female was observed to be a risk factor for brucellosis sero-positvity and among urban dwellers, living in slum areas was also a risk factor although the overall risk was not different among urban, peri-urban and rural areas of the Kampala economic zone.

Resumo Limpo

ckground retrospect casecontrol studi undertaken examin spatial risk factor human brucellosi kampala ugandamethod inform age sex month diagnosi deriv record plate agglutin test undertaken mulago hospit kampala inform parish lcs patient resid sourc outpati registr book inpati fractur case select use control use match base age sex month diagnosi locat case control obtain calcul cartesian coordin centroid parish level lc polygon spatial scan statist appli test diseas cluster parish classifi accord level urban urban periurban ruralresult signific femal male found show seroposit brucellosi compar sex ratio total outpati addit femal brucellosi patient found signific older male patient spatial cluster brucellosi case observ includ around mulago hospit radius km p influenc proxim hospit observ brucellosi case signific differ observ control diseas cluster confound differ catchment area case control level urban associ incid brucellosi live slum area signific risk factor among urban dweller odd ratio ci conclus femal observ risk factor brucellosi seropositv among urban dweller live slum area also risk factor although overal risk differ among urban periurban rural area kampala econom zone

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