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Received Nov 30, 2017; Accepted Mar 1, 2018
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1. Introduction
Brucellosis is one of the most common zoonotic infections globally [1, 2]. The disease is transmitted to humans by direct/indirect contact with infected animals or through the consumption of raw meat and dairy products [3, 4]. The main transmission routes are digestive tract, skin, and mucosal and respiratory tract contact with blood body fluids and aerosols.
Brucellosis has a wide spectrum of clinical manifestations, often lacks specificity, may last from several days to more than a year, is often misdiagnosed, and therefore causes inadequate therapy and prolonged illness can cause a severely debilitating and disabling illness. Patients may show fever, sweating, fatigue, and osteoarthritis [5] and even more serious conditions in different organ systems [6]. Brucellosis not only causes huge economic loss to the society by influencing the production of animal husbandry, but also threatens the human’s physical and mental health [7].
Brucellosis was first reported in China in 1905 [8]. In recent years, human brucellosis incidence has increased sharply [9, 10]. Nationwide surveillance data indicated that the total incidence rate of human brucellosis in mainland China increased from 0.92 cases/100,000 people in 2004 to 4.2 cases/100,000 people in 2014 [11–13]. Currently, human brucellosis remains one of major public health issues in China.
This study presents a systematic review of scientific literature published before December 2016 identified as relating to clinical features of brucellosis in China. The objectives of this review were to identify those gaps in the literature of epidemiology, clinical manifestations, contact history, laboratory tests, and misdiagnosis of human brucellosis in China and provide further evidence for the accurate diagnosis, particularly in assessing severe, debilitating sequelae of human brucellosis.
2. Methods
2.1. Search Strategy
We performed a systematic review of the literature to identify articles relating to clinical features of human brucellosis in China. With assistance of a professional medical librarian we electronically searched the literature in Wan Fang Data, Wei Pu Data, CNKI, Medline, Cochrane Library, and PubMed with MESH and keyword subject headings “brucellosis,” “malta fever,” “brucella melitensis,” or “brucella abortus,”...