Seroprevalence of Brucella Infection and Its Determinants Among Pregnant Women Attending Antenatal Care in Burao City: At the Human Livestock Interface in Northeast Somaliland, Somalia.

Abstract

Background: Brucellosis typically spreads from animals to humans through contact with infected animals or their byproducts. This zoonotic disease can have serious consequences and is often caused by contact with infected livestock or their products, such as contaminated dairy, posing significant risks during pregnancy. This study aimed to evaluate the prevalence of Brucella infection among pregnant women residing in the Burao City area of northeast Somaliland, in environments where human-animal interaction is a frequent occurrence. Therefore, it is important to identify the factors that contribute to its occurrence. Methods: From January to June 2024, this cross-sectional study was conducted at five healthcare facilities that provide antenatal care. Pregnant women who attended these facilities were invited to participate in this study. A structured questionnaire was used to collect data on sociodemographic background, obstetric history, behaviors, and practices related to brucellosis. The presence of Brucella antibodies in the serum was detected using the Rose Bengal Plate Test (RBPT), and positive samples underwent further analysis with enzyme-linked immunosorbent assays (ELISA) to distinguish between IgG and IgM antibodies. Bivariate analysis was conducted to identify variables associated with Brucella seropositivity, whereas multivariable logistic regression was used to determine independent factors linked to Brucella seropositivity after adjusting for other variables. Results: A total of 216 participants were included in the study. The overall prevalence of Brucella infection, determined using the RBPT, was 25.93% (56 out of 216). Among those who tested positive, 61.14% (34 out of 56) had IgG antibodies and 21.42% (12 out of 56) had IgM antibodies against Brucella, as confirmed by ELISA, and IgM ELISA testing revealed 5.6% of pregnant women had recent Brucella infections. Brucella seropositivity was found to be less likely for individuals who frequently interacted with manure, as indicated by an adjusted odds ratio of 0.052 and a 95% confidence interval of 0.016-0.169. Consumption of raw animal milk (AOR 4.84, 95% CI 2.24-10.42), and involvement in assisting animals during childbirth (AOR 4.26, 95% CI 1.065-17.0) significantly increased the risk of Brucella seropositivity. Conclusion: Brucellosis poses a considerable public health threat to pregnant women residing in areas with frequent human-animal interactions. Factors such as the consumption of raw animal products, intimate contact with animals, and involvement in assisting with animal birth escalate this risk. These findings emphasize the importance of implementing strategies aimed at reducing exposure and enhancing the timely detection of brucellosis among pregnant women.