Identifying ways to reduce the spread of brucellosis by consulting the community: A mixed methods study

Abstract

BackgroundBrucellosis is a zoonotic disease endemic in the Middle East and in Israel, with hundreds of cases each year, mostly in the Arab population. AimTo identify solutions for reducing the spread of brucellosis that are acceptable among the Arab community in Israel. MethodsThe study comprised two stages and involved farmers, non-industrial cheese-makers, and the general public recruited from towns previously exposed to brucellosis in the North (majority Arab non-Bedouin) and South (majority Bedouin population) of Israel. In the first qualitative stage, interviews and focus groups were conducted with 88 individuals, to collect suggested solutions for reducing the spread of brucellosis. Based on qualitative findings, a quantitative survey was conducted to assess the acceptability of proposed solutions. ResultsIn the qualitative stage, diverse solutions were proposed regarding infrastructure, economic and regulatory issues as well as education. Six hundred and thirteen people rated the proposed interventions. Solutions rated highly were routine free veterinary visits (preferred solution for 27 % respondents), increasing control on illegal trade in animals from affected areas (18 %), the option to insure flocks, guaranteeing compensation after culling (18 %), support and guidance for small businesses which may facilitate adherence to regulations, lectures provided by the healthcare services or the Ministry of Health (24 %). Differences were found between communities in the north and south of Israel in the solutions suggested. ConclusionsSeveral possible strategies were identified that could enhance reduced disease spread. A multifaceted approach is required, combining raising public awareness, better disease reporting in both animals and humans, improvements in infrastructure and better surveillance for livestock. Highlighting how different sectors contribute to the spread of the disease may raise awareness of the agricultural, technological and regulatory aspects and improve willingness to change.