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Meta-Analysis
. 2020 May 11;14(5):e0008164.
doi: 10.1371/journal.pntd.0008164. eCollection 2020 May.

Occupational exposure to Brucella spp.: A systematic review and meta-analysis

Affiliations
Meta-Analysis

Occupational exposure to Brucella spp.: A systematic review and meta-analysis

Carine Rodrigues Pereira et al. PLoS Negl Trop Dis. .

Abstract

Brucellosis is a neglected zoonotic disease of remarkable importance worldwide. The focus of this systematic review was to investigate occupational brucellosis and to identify the main infection risks for each group exposed to the pathogen. Seven databases were used to identify papers related to occupational brucellosis: CABI, Cochrane, Pubmed, Scielo, Science Direct, Scopus and Web of Science. The search resulted in 6123 studies, of which 63 were selected using the quality assessment tools guided from National Institutes of Health (NIH) and Case Report Guidelines (CARE). Five different job-related groups were considered greatly exposed to the disease: rural workers, abattoir workers, veterinarians and veterinary assistants, laboratory workers and hunters. The main risk factors and exposure sources involved in the occupational infection observed from the analysis of the articles were direct contact with animal fluids, failure to comply with the use of personal protective equipment, accidental exposure to live attenuated anti-brucellosis vaccines and non-compliance with biosafety standards. Brucella species frequently isolated from job-related infection were Brucella melitensis, Brucella abortus, Brucella suis and Brucella canis. In addition, a meta-analysis was performed using the case-control studies and demonstrated that animal breeders, laboratory workers and abattoir workers have 3.47 [95% confidence interval (CI); 1.47-8.19] times more chance to become infected with Brucella spp. than others individuals that have no contact with the possible sources of infection. This systematic review improved the understanding of the epidemiology of brucellosis as an occupational disease. Rural workers, abattoir workers, veterinarians, laboratory workers and hunters were the groups more exposed to occupational Brucella spp. infection. Moreover, it was observed that the lack of knowledge about brucellosis among frequently exposed professionals, in addition to some behaviors, such as negligence in the use of individual and collective protective measures, increases the probability of infection.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA Flow diagram of selected studies.
Fig 2
Fig 2. Geographical and temporal distribution of the selected articles included in the present study.
(a) Distribution and frequency of occupational brucellosis studies published by country (performed with aid of online dataset: https://commons.wikimedia.org/wiki/Atlas_of_the_world). (b) Distribution and frequency of occupational brucellosis studies published by continent and decade, from 1962 to 2018.
Fig 3
Fig 3
Distribution of occupations affected by occupational brucellosis by country, including the and time period when the studies were performed, selected by this systematic review (a) and the Brucella species identified through direct diagnostic methods (b).
Fig 4
Fig 4. Forest plot of odds ratio for brucellosis among risk work groups (animal breeders, farmers, abattoir workers and laboratory workers) exposed and other individuals not occupationally exposed to Brucella spp. during their labor activities.
Year indicates the period in which study was performed.

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