Prevalence Of Brucellosis Among Women Presenting With

Research Article

Prevalence of Brucellosis among Women Presenting with

Abortion/Stillbirth in Huye, Rwanda

Nadine Rujeni1 and Léonidas Mbanzamihigo2,3

1 College of Medicine andHealth Sciences, University of Rwanda,Huye Campus, P.O. Box 56, Butare, Rwanda

2Veterinarians without Borders-Belgium, P.O. Box 35, Butare, Huye, Rwanda

3UCL, Louvain Cooperation au D´eveloppement, Avenue Mugamba 35, P.O. Box 2076, Rohero II, Bujumbura, Burundi

Correspondence should be addressed to Nadine Rujeni; nrujeni@gmail.com

Received 19 February 2014; Accepted 12 June 2014; Published 29 June 2014

Academic Editor: Aditya Prasad Dash

Copyright © 2014 N. Rujeni and L. Mbanzamihigo. This is an open access article distributed under the Creative Commons

Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is

properly cited.

Theincidence of human brucellosis is not documented in Rwanda despite several reports on thedisease incattle.Because brucellosis

has been associated with abortion, the aim of this study was to investigate the prevalence of positive serology in women presenting

with abortion and/or stillbirth. The study was done in Huye District, in the Southern Province of Rwanda, and the patients were

recruited from both the University Teaching Hospital of Butare (CHUB) and Kabutare District Hospital. Serum samples were

collected and the Rose Bengal plate test (RBPT) was performed on each sample. A questionnaire was also used to investigate

potential contacts with animals and/or consumption of raw milk. A total of 60 women were recruited and 15 (i.e., 25%) were

Brucella seropositive.The questionnaire showed that those with seropositivity either were in contact with domestic animals (cattle,

goat, or sheep) or were consuming raw cow’s milk. Human brucellosis appears to be of public health importance in Rwanda and

more attention should be drawn on the disease.The current study provides a basis for larger studies to establish the incidence of

human brucellosis in Rwanda. More mechanistic studies will also demonstrate the pathogenicity of Brucella in human placentas.

1. Introduction

Brucellosis is a debilitating zoonotic disease due to bacteria

of the genus Brucella. Infection is acquired either by contact

with infected animals or consumption of contaminated milk

or dairy products. The disease has major economic impact

not only due to time lost by patients from normal daily

activities but also due to the loss in animal husbandry [1, 2].

Indeed, brucellosis is characterised by abortion and loss of

fertility in farm animals [2–4]. In humans, the symptomatology

is not specific, and this makes the diagnostic quite

challenging. Patients may present with an intermittent fever,

joint pain (including arthritis), neurologic manifestations,

and so forth [5]. The association between abortion/stillbirth

and brucellosis in humans is controversial [6]. This could be

due to the absence of erythritol (a 4-carbon sugar alcohol

which is the preferred carbon source for Brucella) in human

placentas as opposed to ruminant placentas [7, 8]. However,

a recent study has demonstrated that Brucella replicates in

several human trophoblast subpopulations and can interfere

with the invasive capacity of extravillous trophoblast-like

cells in vitro [9]. Studies investigating an association between

human brucellosis and abortion in vivo are scarce.

In Rwanda, the incidence of human brucellosis is not

documented despite a number of reports on cattle brucellosis

[10].Because of the potential risk of Brucella-associated abortion

in infected women, the aim of this study was to establish

the seroprevalence of brucellosis in women presenting with

abortion/stillbirth.This study also aims to document the risk

factors for human brucellosis and the potential reservoir of

pathogens.

2. Materials and Methods

2.1. Study Area and Population. The study was conducted in

Huye District, located in the Southern Province of Rwanda.

Blood samples were collected from women presenting with

abortion/stillbirth of unknown cause at the district hospital

(Kabutare) and the referral hospital (ButareUniversity Teaching

Hospital).

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