Epidemiological Characteristics and Trend in the Incidence of Human Brucellosis in Iran from 2009 to 2017

Spatio-temporal analysis of human brucellosis distribution in Neyshabur, Iran from 2015 to 2022, a cross-sectional study

BACKGROUND

Human brucellosis is a global endemic disease and a significant public health concern. This cross-sectional study aims to explore the characteristics of human brucellosis, as well as its spatial and temporal clustering.

METHODS

This cross-sectional study analyzed the population infected with human brucellosis in Neyshabur, Iran from 2015 to 2022. Data were obtained from the Neyshabur health center. Spatial analysis was conducted using Anselin Local Moran's I and Global Moran's I with ArcGIS 10.8.2. Descriptive statistical analyses were performed using SPSS 26.

RESULTS

During the study period, a total of 4568 brucellosis patients were reported. The incidence of disease was higher in men with 55.37%. The majority of patients belonged to the 30 to 39-year-old age group. Temporal clustering analysis revealed a peak incidence between March and June. The highest incidence rates were observed in spring and summer, with 34.76% and 33.84% of cases, respectively. Spatial clustering analysis indicated a higher prevalence in the southern and southeast districts of Neyshabur. The results of Global Moran's I analysis indicated that the distribution of brucellosis was not clustered in Neyshabur (P-value > 0.05).

CONCLUSION

The findings of this study highlight the importance of educational programs for mothers and animal vaccination strategies, particularly in the months leading up to the peak brucellosis season in high-incidence areas. Further research is needed to assess the coverage of livestock vaccination and its impact on human brucellosis rates.

Social network analysis of key stakeholders in Brucellosis prevention in Western Iran

BACKGROUND

Brucellosis remains a persistent public health challenge in Iran, particularly in rural regions such as Lorestan province, due to systemic, economic, and cultural barriers. Effective disease control requires multisectoral collaboration among stakeholders. This study aimed to map the stakeholder network involved in brucellosis prevention in Lorestan province, identify gaps in coordination, and provide actionable recommendations for improving control strategies.

METHODS

This cross-sectional study employed social network analysis (SNA) to explore the relationships among key stakeholders in brucellosis prevention. Data were collected through a structured questionnaire administered to 75 experts from various sectors, including health, veterinary, agriculture, and non-governmental organizations. The SNA evaluated network density, clustering coefficient, and centrality metrics to determine the levels of collaboration and influence among stakeholders.

RESULTS

The analysis revealed a moderately dense network (density: 0.2745; clustering coefficient: 0.2839) with central roles played by the Veterinary Organization of Lorestan Province, Lorestan University of Medical Sciences, and the Ministry of Agriculture. These organizations exhibited high levels of influence, support, and interest in brucellosis prevention. However, limited involvement of community-based organizations and environmental agencies was identified, highlighting a critical gap in grassroots engagement. Fragmented coordination was particularly evident in rural areas, where traditional livestock practices, inadequate veterinary services, and the consumption of unpasteurized dairy products perpetuate disease transmission. Economic constraints, such as the high cost of vaccines, along with limited public awareness, further hinder effective control efforts.

CONCLUSIONS

Brucellosis prevention in Lorestan province requires a comprehensive, multisectoral approach. The adoption of a One Health framework can improve collaboration among stakeholders, enhance resource allocation, and address systemic barriers. Community engagement and intersectoral coordination are essential for improving public awareness and compliance with preventive measures. These findings provide a foundation for developing a National Brucellosis Control Program and inform strategies to mitigate zoonotic diseases in similar high-risk regions.

Prediction and control for the transmission of brucellosis in inner Mongolia, China

Brucellosis, a zoonotic infectious disease caused by the Brucella genus, remains a significant global public health concern, with Inner Mongolia, China, being a notable hotspot affecting both human health and livestock. In response to this, we developed a dynamic SEIVWShIahIch model to simulate the transmission of brucellosis in Inner Mongolia. We calculated the basic reproduction number (R0 = 2.86), indicating a severe epidemic trend with cases expected to increase over the coming decades. The model was fitted to human brucellosis data, and key transmission parameters were estimated to predict future trends. We also evaluated the impact of various control measures, including vaccination, disinfection, culling, and health education. While these measures positively influence disease control, they cannot completely eliminate brucellosis, suggesting that a single control strategy is insufficient. Combining vaccination and culling proved more effective, with identified threshold values for R0 and to keep R0 < 1. Our findings indicate that a comprehensive strategy integrating vaccination, culling, disinfection, and health education is essential for effectively curbing brucellosis in Inner Mongolia, providing a strong foundation for optimizing future prevention and control strategies.

Long ignored but making a comeback: a worldwide epidemiological evolution of human brucellosis

Brucellosis is a commonly neglected zoonosis that remains a serious global public health concern. The epidemiological evolution of human brucellosis has considerably changed over the past few decades, and epidemic geography is continuously expanding. Human brucellosis is emerging and re-emerging, and is imported from areas where it is endemic due to travel, immigration, and international trade. The disease continues to be prevalent in Asia and Africa, including West Asia, Central Asia, North Africa, and East Africa, with the highest incidence in Syria, Kyrgyzstan, Mongolia, Iran, Algeria, and Kenya. Re-emerging cases are frequently recorded in places where brucellosis has been controlled, such as Bosnia, Herzegovina, Azerbaijan, and the USA. In countries with a high disease burden, disease control and eradication have been extremely difficult because of livestock farming being the only source of livelihood, unique religious beliefs regarding animals, nomadic lifestyle, and low socioeconomic levels. Interventions focused on protecting livestock keepers are needed, particularly for those assisting with goat and sheep births and the consumption of raw dairy products. Notably, in most countries with a high disease burden, each period of several years with a low incidence rate was followed by a subsequent increase in cases, highlighting the necessity of continuous investment and surveillance. In addition, advocacy for the inclusion of brucellosis as a globally mandated reported disease, strict restrictions on animal movement, mandated consumption of pasteurized milk, and health education are needed. This study will help form an evidence-based strategy for international organizations to curb the future spread of brucellosis.

Bovine brucellosis, associated risk factors and preventive measures in industrial cattle farms

Effective management of brucellosis in human populations is closely tied to controlling the disease in domestic livestock. This study focused on identifying determinants of brucellosis prevalence in mixed industrial dairy and beef cattle farms within Isfahan Province, Iran. Employing a case control design, we compared 32 ranches with documented brucellosis within the previous year (12 months) to 38 farms with no brucellosis during the same timeframe. The comparison examined the farms' adherence to health protocols for raising cattle. Utilizing multivariable logistic regression, the study identified several significant risk factors linked to brucellosis prevalence. These included cleaning milking accessories with a water and chlorine solution (OR 0.25, 95%CI 0.06 to 0.99), cleaning water troughs daily (OR 0.20, 95%CI 0.04 to 0.89), the cows' density per square meter (OR 0.14, 95%CI 0.03 to 0.75), being within 2000 m of another cattle ranch with brucellosis (OR 4.02, 95%CI 1.09 to 14.84) and ovine farms situated within a 500-m radius (OR 8.43, 95%CI 1.66 to 42.70). No meaningful difference was observed in vaccination frequency between infected and non-infected farms (P = 0.645). While vaccination is essential for preventing bovine brucellosis, robust biosecurity measures are crucial for effective disease management.

Epidemiological characteristics and spatio-temporal clusters of human brucellosis in Inner Mongolia, 2010-2021

BACKGROUND

Brucellosis poses a significant public health challenge in China. Inner Mongolia, characterized by its developed livestock industry, is the most severe endemic area for human brucellosis. This study aims to describe the epidemiology, explore the spatial-temporal distribution patterns, and clustering characteristics of human brucellosis in Inner Mongolia.

METHODS

Data on human brucellosis cases from 2010 to 2021 were obtained from the Centers for Disease Control and Prevention in Inner Mongolia. Spatial autocorrelation analysis was used to identify high-risk areas, while spatial-temporal scan statistics were employed to detect changes in clusters over time.

RESULTS

A total of 153,792 brucellosis cases were reported in Inner Mongolia from 2010 to 2021, with an average annual incidence rate of 52.59 per 100,000 persons. The incidence showed a decreasing trend from 2010 to 2016, followed by a significant increase from 2016 to 2021. The disease exhibited distinct seasonality, peaking in spring and summer (March to August). Middle-aged individuals, males, and farmers/herdsmen had higher incidence rates. Spatially, incidence rates decreased from north to south and from the central and eastern regions to the west. Clear spatial clusters were observed during 2010-2013 and 2016-2021 in the global Moran's I test. Local spatial autocorrelation analysis revealed that high-high clusters expanded from the central and eastern regions towards the west over time. Spatio-temporal scan analysis further indicated that high-risk clusters were primarily concentrated in the central and eastern regions, with a continuous expansion towards the west and south, leading to an increasingly broad geographical spread.

CONCLUSION

Human brucellosis cases in Inner Mongolia exhibit spatio-temporal clustering, with spatial concentration in the central and eastern regions, but also observed expansion towards the western and southern regions. The most of cases occur between March and August each year. For high-risk areas and populations, more timely and effective prevention and control measures should be implemented to mitigate the spread of brucellosis and protect public health.

Epidemiology of brucellosis in Mazandaran, North of Iran in a nine-year period (2009-2017)

Background

Brucellosis is a common disease between humans and animals that still exists in most parts of Iran. This study investigated the epidemiology of brucellosis in Mazandaran province, Iran, during a nine-year period from the beginning of 2009 until the end of 2017.

Methods

This descriptive-analytical study was conducted based on the guidelines of Iran's Ministry of Health and Medical Education on the data of 3732 brucellosis patients. The data were retrieved from the private and public laboratories gathered in a Ministry's database. We used the generalized estimating equation (GEE) for the Poisson regression model (Poisson GEE) to examine the disease incidence based on the studied variables.

Results

The age-standardized incidence rate has been 13.2 per 100,000 people (15.6 in men and 21.3 in rural areas). The highest rate (17.2) was in 2012 and the lowest (10.6) was in 2014. The cities of Galugah (35.0) and Qaemshahr and Fereydunkenar (3.0) had the highest and lowest incidence rates. The patients' professions had been 30% housewives, 14.9% ranchers, and 14.4% livestock-related professions. The highest standard incidence was in people older than 55 years old. The results of the Poisson GEE regression model showed that the disease incidence has been higher in men compared to women and in rural compared to urban areas (risk ratio = 1.5, 3.4, P = 0.001).

Conclusion

Mazandaran faces the risk of increased brucellosis incidence rate. Taking preventive measures, including educating people, are recommended for the near future.

Qualitative Analysis of Newborn Hearing Screening Program in Iran

Background

Early diagnosis of hearing loss and timely interventions are important to minimize the consequences of this condition, especially for children. This research was conducted to analyze the newborn hearing loss screening program in Iran.

Methods

This qualitative study was conducted using the content analysis method and based on the CIPP model in 2023. The snowball method was used to recruit a sample with maximum diversity. The criteria for selecting people for interviews included having at least three years of experience in the newborn hearing loss screening program and sufficient knowledge in the field. To ensure the reliability of the results, four criteria proposed by Lincoln and Guba were used. Data analysis was conducted by MAXQDA2022 software.

Results

In the current research, using content analysis in the form of the CIPP model, based on the viewpoints of the interviewees (40 people), the management requirements of the newborn hearing loss screening program were categorized into the four main categories of context (texture), input, process, and output. Eight subcategories were identified in the context dimension, four subcategories in the input dimension, seven subcategories in the process dimension, and four subcategories in the output dimension.

Conclusion

According to the findings of this research, in order to properly implement the newborn hearing loss screening program, there is a need to conduct pilot studies, need assessments, evidence-based programs, and epidemiological studies and to prioritize services and resources. Also, communication between service delivery levels needs to be improved, and attention should be paid to personnel motivation and screening programs.

Brucellosis: epidemiology, pathogenesis, diagnosis and treatment-a comprehensive review

Background: Brucellosis is a pervasive zoonotic disease caused by various Brucella species. It mainly affects livestock and wildlife and poses significant public health threats, especially in regions with suboptimal hygiene, food safety, and veterinary care standards. Human contractions occur by consuming contaminated animal products or interacting with infected animals. Objective: This study aims to provide an updated understanding of brucellosis, from its epidemiology and pathogenesis to diagnosis and treatment strategies. It emphasizes the importance of ongoing research, knowledge exchange, and interdisciplinary collaboration for effective disease control and prevention, highlighting its global health implications. Methods: Pathogenesis involves intricate interactions between bacteria and the host immune system, resulting in chronic infections characterized by diverse clinical manifestations. The diagnostic process is arduous owing to non-specific symptomatology and sampling challenges, necessitating a fusion of clinical and laboratory evaluations, including blood cultures, serological assays, and molecular methods. Management typically entails multiple antibiotics, although the rise in antibiotic-resistant Brucella strains poses a problem. Animal vaccination is a potential strategy to curb the spread of infection, particularly within livestock populations. Results: The study provides insights into the complex pathogenesis of brucellosis, the challenges in its diagnosis, and the management strategies involving antibiotic therapy and animal vaccination. It also highlights the emerging issue of antibiotic-resistant Brucella strains. Conclusions: In conclusion, brucellosis is a significant zoonotic disease with implications for public health. Efforts should be directed towards improved diagnostic methods, antibiotic stewardship to combat antibiotic resistance, and developing and implementing effective animal vaccination programs. Interdisciplinary collaboration and ongoing research are crucial for addressing the global health implications of brucellosis.