1679. Brucellosis in rural Narok County, Kenya: A Retrospective Review

BACKGROUND: It is well-documented that the country of Kenya is confronted with a heavy burden of brucellosis, presumably related to consumption of unboiled or fermented milk products (maziwa lala). As a developing country, epidemiologic data defining the prevalence of brucellosis is incomplete and particularly lacking in rural areas of the country. The objective of this study was to establish the rate of brucellosis in patients seen in a rural health clinic in Narok County, an area which has not been previously studied. METHODS: This study was performed at the Ewaso Ngiro Health Center, Narok County, Kenya, which serves a catchment area of 6,573 citizens. A retrospective chart review was conducted for 241 patients seen in December 2018 for acute visits. Medical records were reviewed for evidence of joint pain and other symptoms of brucellosis at the time of presentation and for brucellosis antigen testing results. RESULTS: Of the 241 patient charts reviewed, 78 (71 adult, 7 pediatric) patients had joint pain. Of the 71 adult patients, 21 were male and 49 were female (1 with no gender recorded). 50 patients had Brucella testing performed via serum agglutination, and yielded 14 positive results (13 adult, 1 pediatric). Confirmed brucellosis accounted for 5.8% of all acute visits in December 2018, and 26% of patients presenting with joint pain. In patients with confirmed brucellosis, the average age was 50.2 years (ranging 15–80). There were 8 female cases, 5 male, 1 with gender not recorded. Generalized joint pain was the most common complaint (n = 14), followed by back (n = 6), knee (n = 1), and neck pain (n = 1). CONCLUSION: The prevalence of Brucella disease in rural areas of Kenya, specifically Narok County, is not well studied. This study provides insight into the prevalence of brucellosis and shows that over 25% of patients presenting with joint pain, have brucellosis. Furthermore, 5.8% of all patients seen at the Ewaso Ngiro Health Center during the study period had brucellosis and the overall prevalence of disease in patients who were tested specifically for brucellosis (n = 50), was 28%. This study provides preliminary evidence of a heavy burden of Brucella disease in Narok County and suggests that a follow-up study in this area is warranted to be defined the true prevalence of disease over a longer time frame. DISCLOSURES: All authors: No reported disclosures.