Brucellosis In Iran Research Articles

Spatial Epidemiology and Temporal Trend of Brucellosis in Iran Using Geographic Information System (GIS) and Join Point Regression Analysis: An Ecological 10-Year Study

Background: Brucellosis is one of the common diseases between humans and animals. We aimed to assess the annual incidence rate, the geographical distribution of Malta fever using GIS and its time trend. Methods: This was an ecology study carried out in exploratory mixed design. The study population was the individuals with brucellosis in Iran during the years 2009-2018. Data analysis has been done using Joinpoint regression analysis and GIS at a significant level of α = 0.05. Results: The average annual incidence rate of the disease rate was 19.91 per one hundred thousand people. The trend of the changes in the incidence between 2009 and 2018 has increased and the Annual Average Percent Change increased by 4.6%. However, a joinpoint was observed in 2014 and the incidence has changed significantly at this point in time, so that the annual incidence of the disease has increased more strongly between 2009 and 2014 (APC=17.1%) and then from 2014 to 2018, the incidence of the disease has decrease (APC=-9.2%). The spatial distribution showed that the western and northwestern provinces have high incidence rate, but the northern and southern provinces have low incidence rate. Conclusion: The incidence of brucellosis in Iran is higher than in developed countries and similar to developing countries. Ten-year trend of disease incidence increased slightly, but it has decreased in recent years. It is necessary to improve the surveillance system and increase facilities for prevention and treatment in the high-risk areas including the west and northwest of Iran.

Equine brucellosis in Iran: serological, bacteriological and molecular analysis.

Equine brucellosis significantly impacts the health and functionality of horses, leading to complications such as bursitis infection, septic tenosynovitis, septic arthritis, and non-specific lameness resulting from joint infections. In the present study, we used the Rose Bengal plate agglutination test (RBPT), serum agglutination test (SAT), and the 2-mercaptoethanol (2-ME) assays to find equine brucellosis. From June 2018 to September 2022, 876 blood samples were randomly taken from apparently healthy racing horses in certain parts of Iran, such as Kerman, Isfahan, Tehran, Qom, and Kurdistan. DNA extraction was carried out directly on all 63 serum samples identified as seropositive through RBPT. An additional 30 seronegative serum samples were also randomly chosen for study. Bacterial culture was also done on milk, blood, and vaginal swabs taken from seropositive horses.The bacteria that were found in the samples were then put through Bruce-ladder PCR. Our results indicated that 63 (7.1%), 21 (2.3%), and 2 (0.2%) of horses were seropositive using RBPT, SAT, and 2-ME, respectively. Also, none of the 30 DNA-extracted serum samples from seronegative horses tested positive for Brucella DNA, while 44.5% (28/63) of the DNA samples from seropositive horses yielded positive results for Brucella DNA. Out of the seropositive samples, 26 had DNA from Brucella abortus and 2 had DNA from Brucella melitensis. Also, B. melitensis biovar 1 was found in two milk samples from mares in the provinces of Kerman and Isfahan. It was identified using classical biotyping, and molecular assays. It was seen that some of healthy racing horses in some parts of Iran had antibodies against Brucella. The bacteriology and PCR methodologies provide a more comprehensive and reliable means of identifying Brucella spp. infections in horse, especially when the RBPT test came back positive. This underscores the imperative for employing molecular, bacterial, and serological methods in the diagnosis and monitoring of this zoonotic infection. Additionally, this finding suggests that Brucella is being transmitted to equine hosts as a result of its presence in ruminants. The mechanism of transmission may involve interactions between infected ruminants and susceptible equines. This discovery is significant as it underscores the potential cross-species transmission of Brucella and highlights the importance of understanding and managing the spread of the pathogen in both ruminant and equine populations.

A study of rural populations’ knowledge, attitude, and practice about brucellosis: a descriptive, cross-sectional, multicenter study

ObjectiveBrucellosis is a highly contagious disease which is transmitted from animals to humans. One of the populations at high risk of infection is those living in rural areas. The present study was conducted to investigate rural populations’ knowledge, attitude, and practice about brucellosis in Iran. The study used a descriptive, cross-sectional design to assess 300 individuals who were living in rural areas. The subjects were selected using convenience sampling from six villages located in the south of Iran. The data gathered were analyzed using Analysis of variance (ANOVA), and Pearson correlation coefficient in SPSS version 23.ResultsFrom the 300 individuals who were enrolled in this study, 189 were male and 111 were female. The mean age of the participants was 48.27 ± 4.28 years. The mean scores of the study population’s knowledge, attitude, and practice about brucellosis were found to be low. A significant direct correlation was found between the subjects’ knowledge, attitude, and practice regarding brucellosis.

Characterization of Brucella spp. circulating in industrial dairy cattle farms in Iran: a field study 2016 - 2023.

Bovine brucellosis, an infectious disease transmitted by Brucella melitensis and Brucella abortus, presents a significant zoonotic risk for agricultural economics and animal health. The primary objective of this study was to present a comprehensive understanding of the prevalence and features of Brucella strains within the industrial dairy farming sector in Iran. Rose Bengal plate test, standard agglutination test, and indirect enzyme linked immunosorbent assay tests were used to confirm all seropositive animals. A total number of 1,311 bovine samples from seropositive animals including were collected from 224 farms in 21 provinces of different regions of Iran and examined. The discovered Brucella isolates were phenotyped and molecularly characterized. The isolates were all B. abortus or B. melitensis. Bacteria analysis revealed that 70.53% of seropositive farms were tested positive for Brucella strains, predominantly B. melitensis biovar 1 (43.42%) and B. abortus biovar 3 (27.11%). Geographical distribution revealed that B. melitensis biovar 1 was the most common in dairy cow farms (16 provinces), followed by B. abortus biovar 3 (six provinces). Also, the prevalence of B. melitensis biovar 2, B. melitensis biovar 3, B. abortus biovar 1, B. abortus biovar 2 and RB51 vaccine were restricted to certain provinces. AMOS (abortus melitensis ovis suis)-polymerase chain reaction and Bruce-ladder PCR confirmed species identification. These results highlighted the complexity of bovine brucellosis in Iran and illustrated that B. melitensis was spread from small ruminants to cattle. This study provided important epidemiological insights for targeting future brucellosis control programs in the Iranian dairy farms.

The Control Program of Brucellosis by the Iranian Veterinary Organization in Industrial Dairy Cattle Farms.

Brucellosis is a zoonotic infection in livestock that induces a major public health concern in developing countries, including Iran. Despite the efforts of the Iranian veterinary organization (IVO) to control brucellosis, it is still prevalent in domestic animals. In this regard, the present study aimed to evaluate the efficiency of the control strategy used by the IVO in infected herds on serological, cultural, and molecular methods. For this purpose, blood specimens were sampled from a total of 8750 vaccinated dairy cattle in two Brucella-infected farms. These farms were recognized as positive for Brucella by a screening program. Sera were evaluated by the Rose Bengal Plate Test and Wright test analysis. Positive dairy cattle were slaughtered under IVO supervision. The remaining cattle were evaluated every 3 weeks and positive animals were slaughtered. This procedure continued until the remaining animals revealed three successive negative responses in serological tests. Several lymph nodes and milk samples were collected from 164 seropositive cattle and subjected to bacterial isolation and confirmation by Bruceladder-polymerase chain reaction. Brucella melitensis biovar 1 and RB51 vaccine strains were recovered from milk and lymph node samples, respectively. Shedding of B. melitensis in the milk of vaccinated cows is a serious problem resulting in the further spread of brucellosis. The policy of "test and slaughter" performed on infected dairy cattle farms showed their usefulness for the control of brucellosis outbreaks. For the uncontrolled spread of brucellosis in Iran, effective control of bovine brucellosis required several serological surveillances to identify infected herds, eradication of the reservoirs, and vaccination of young heifers with RB51.

Trends in the Epidemiology of Brucellosis Cases in Iran during the Last Decade.

Brucellosis is one of the most important zoonotic diseases that impose a serious public health burden on some countries in the world. Annually, the WHO reports more than 500000 new cases of human brucellosis. The disease is endemic in most parts of Iran; especially, in areas where people live in close contact with infected animals. According to data from the Iranian Ministry of Health, the average incidence of brucellosis in Iran was 22 cases per 100000 population, with a decreasing trend of surveillance. This cross-sectional survey was carried out within 2011-2020 in all provinces of Iran and from patients with clinical symptoms. During the last decade, a total of 173526 cases were reported from different provinces of Iran, with a higher frequency of occurrence in males (58.2%) living in rural areas (77%), as compared to those in urban areas (23%). Moreover, brucellosis was more common in the summer season (June) and most of the cases were via contact with infected livestock (91%) and consumption of unpasteurized dairy products (78% in rural areas and 76% in the urban areas). The failure to effectively control brucellosis may be attributed to lack of knowledge about the disease, consumption of unpasteurized dairy and raw meat, lack of proper and safe vaccines for prevention and eradication programs, lack of rapid detection systems, and ineffective methods of isolating infected animals. Therefore, education and advancement of people's knowledge are key to the prevention and control of the disease.

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

Background: The development of preventive measures and promotion of healthcare delivery systems for disease management is dependent on detecting the incidence rates of the diseases and important risk factors. The current study aimed to determine some epidemiological indices and trends of the human brucellosis incidence in Iran between 2009 and 2017. Study design: A descriptive cross-sectional study. Methods: In the current study, online data were gathered from all cases of brucellosis who were potentially or definitely diagnosed and registered in medical centers, hospitals, laboratories, and private clinics in all districts of Iran. Epidemiologic questionnaires were used to collect data on demographic and background characteristics, risk factors, high-risk behaviors, and lab test results, respectively, based on the national brucellosis control plan. Results: A total of 138,448 cases of brucellosis have been studied in Iran from 2009 to 2017. The highest (25.89) and the lowest (12.07) incidence rates were observed in 2014 and 2009, respectively. In this nine-year study, the highest incidences were reported in the Hamadan, Lorestan, Kurdistan, and Kermanshah provinces. The cumulative percentages of the disease were estimated for different variables at the following rates: by gender: 57.9% for males; by age groups: 36.2% and 16.7% for the 25-44 and16-24 years age groups, respectively; by occupation: 33.2% for housewives; and by residential area: 75.7% for rural residents. Conclusions: Based on the obtained results, although the incidence of human brucellosis in Iran has declined since 2015, the number of cases has remained high.

The Incidence and Geographical Distribution of Brucellosis in Iran Using Geographic Information System and Prediction of its Incidence in 2021.

Brucellosis is one of the most challenging health issues in many developing countries including Iran. The purpose of this study is to investigate the incidence and geographical distribution of brucellosis using Geographic Information System (GIS) and to predict its incidence in Iran in 2021. This is a descriptive-analytical cross-sectional study, which contains spatial and climatic information along with the prevalence rate of brucellosis in Iran. Disease information was obtained from the National Center for Infectious Diseases Management during 2011-2015. Then, Arc GIS version 9.3 was used to plot the geographical maps for the incidence and frequency of the disease. Using the Raster calculator tool, the disease prediction map for the future was plotted. For proper spatial distribution of hot and cold spots, Getis-Ord-Gi statistic was employed. The highest incidence of brucellosis during 2009-2015 was observed in the western provinces of Iran (North Khorasan, South Khorasan and Razavi Khorasan provinces). The incidence of brucellosis in Iran decreased from 2009 to 2011 but it exhibited an increasing trend from 2011 to 2014. The provinces of Kurdistan, Lorestan, Ilam, Zanjan and Kermanshah may be among the hot spots in terms of brucellosis incidence in 2021. We predicted significant variations in brucellosis risk distribution in Iran in the coming years. In the western and northwestern provinces, which are among the high risk areas for the incidence of this disease in the future, this disease can pose a serious health threat to the residents of these areas.

A policy analysis of agenda-setting of Brucellosis in Iran using a multiple-stream framework: health policy and historical implications.

SummaryBackgroundBrucellosis, a major zoonotic disease, is highly present in Iran, especially in Lorestan province. The aim of this study was to understand the issues related to Brucellosis utilizing the multiple streams framework.MethodsA two-step method was adopted: 1) assessment of brucellosis-related documents and 2) interviews with stakeholders. As a first step, all documents related to Brucellosis were reviewed at provincial and national levels. Policy documentation on health issues included the consultation of guidelines, rules and regulations, websites, reports, books, guides, and conferences. These documents were collected by referring to specialized centers, institutions, and organizations. In the second step, semi-structured interviews were conducted to determine the burden of disease with actors and stakeholders involved with the brucellosis program in the Lorestan province. More in detail, physicians, healthcare workers, managers, policy- and decision-makers were selected for interviews.ResultsThe problem stream was characterized by: 1) high prevalence of the disease, 2) traditional livestock production, 3) unsafe animal slaughtering, 4) centers for the sale and distribution of non-authorized dairy products, 5) raw milk and 6) traditional unsafe dairy products consumption, 7) incomplete livestock vaccination, 8) lack of knowledge of Brucellosis, 9) neighboring countries with high prevalence of Brucellosis, 10) lack of livestock quarantine, and 10) nomadic immigration. The policy stream was characterized by 1) primary healthcare networks, 2) guidelines, 3) medicines, insurance, and 4) diagnostic services. Finally, the political stream was characterized by: 1) support of the University of Medical Sciences, 2) sponsorship by the Ministry of Health and Medical Education, 3) Health transformation plan, and 4) Working Group on Health and Food Security in Lorestan.ConclusionThis study examined the brucellosis-related agenda setting: if different issues are taken into consideration, it can be perceived as a health priority.

Brucellosis in Iranian buffalo: prevalence and diagnostic methods

The water buffalo (Bubalus bubalis) in Iran represent an important source of meat and milk products with high biological value. Given the importance of water buffalo in Iran and the prevalence of brucellosis as one of the most important zoonotic diseases in this ruminant species, this study summarized available data on history, epidemiology, diagnosis, and control of brucellosis in water buffalo from previous studies that have been carried out in Iran. According to the documented data, there are three main groups of Iranian buffalo, including the Khuzestan ecotype (Khuzestan province); the Azary ecotype (Western/ Eastern Azarbaijan and Ardabil provinces); and the North ecotype (Gylan and Mazandaran provinces). Preliminary studies conducted on Iranian buffaloes either by serological or molecular tools reported that buffaloes' infection occurred due to natural exposure to a wild strain of Brucella abortus and Brucella melitensis. Previous studies dealing with brucellosis in Iranian buffalo are next to none. This review notifies the importance of reliable and detailed epidemiological investigations of Iranian buffaloes through continuous monitoring systems of the health status of buffalo populations. Continuous test and slaughter strategy, vaccination, and re-planning of veterinary activities are required to mitigate buffalo's role in disseminating and maintaining brucellosis in Iran.

A review of brucellosis in the Middle East and control of animal brucellosis in an Iranian experience

To describe brucellosis infectious as a zoonotic disease, which is caused by Brucella spp. Brucellosis is considered to be a major health and economic challenge in developing countries, including Iran. This study focuses on epidemiology human's and animal's brucellosis and disease control strategies. Test-and-slaughter technique and extensive livestock vaccination programs are used for eradication of brucellosis. Test-and-slaughter is a general policy in Middle Eastern countries to eradicate the disease. Under this program, the Rose Bengal plate test is used as a screening measure to identify the infected herd, whereas the complement fixation test is applied as a confirmatory test. The prevalence of bovine brucellosis in 2015–2016 ranged between 7.2 and 18.1% in Kuwait and Jordan and ranged between 3 and 3.1% in Iraq and Iran in 2012–2014. Prevalence of goat brucellosis (Brucella melitensis) was 3.5% in Iran in 2014. Test-and-slaughter is used in most of the countries where the prevalence rate of the disease does not exceed 2%. Since 1963, testing the vaccine efficacy in goats and sheep has proven that vaccination can decrease the epidemic rate of the disease from 45 to 1.8%. This study indicated the test-and-slaughter technique alone has not proven successful in the eradication of brucellosis in Iran, and animal vaccination is essential to the control and eradication of animal and human brucellosis.

Epidemiological, molecular characterization and risk factors of human brucellosis in Iran

Objective: To determine epidemiological, molecular characterization, and potential risk factors of human brucellosis.Methods: This descriptive study was carried out in the clinical setting in Iran between 2017 and 2018. A total of 297 participants enrolled in the study. The sample size was calculated based on the occurrence rate of brucellosis in different areas. Patients were assessed using serological tests and conventional culture methods. Phage and multiplex PCR methods typed all of Brucella isolates. Potential risk factors of disease were determined.Results: A total of 141 of 297 (47.5%) Brucella strains were isolated and all of them were detected as Brucella melitensis biovar 1. Based on serologic titers, high culture positivity was recorded at 1/640 titer (P<0.006). The risk factors for brucellosis were patients older than 40 years (OR=2.23, 95%CI: 1.4-3.55, P=0.001), animal keeper (OR=7, 95%CI: 1.51-32.41, P=0.005), housewife (OR=8.76, 95%CI: 1.85-41.37, P=0.002), farmer (OR=6.42, 95%CI: 1.21-33.97, P=0.019), and contact with animal (OR=1.31, 95%CI: 0.60-2.85, P=0.005).Conclusions: To the best of our knowledge, this is the first comprehensive report from Iran presenting the detection of Brucella species by the multiplex PCR. Brucella melitensis biovar 1 is still the dominant causative agent in Iran. The consumption of unpasteurized dairy products, living in rural areas, and animal contact were risk factors of brucellosis.

Epidemiological Features of Human Brucellosis in Iran (2011-2018) and Prediction of Brucellosis with Data-Mining Models.

Brucellosis is known as the major zoonotic disease. We aimed to compare the performance of some data-mining models in predicting the monthly brucellosis cases in Iran. Population-based cohort study. Three data mining techniques including the Support Vector Machine (SVM), Multivariate Adaptive Regression Splines (MARS), and Random Forest (RF) besides to one classic model including Auto-Regressive Integrated Moving Average (ARIMA) was used to predict the monthly incidence of brucellosis in Iran during 2011-2018. We used several criteria (root mean square error (RMSE), mean absolute error (MAE), coefficient of determination (R2) and intra-class correlation coefficient (ICC) for appraising the accuracy of prediction and performance of our models. All analysis was done using free statistical software of R3.4.0 RESULTS: Overall 118867 cases (with a mean age of 34.01±1.65 yr) of brucellosis were observed and seven-year incidence rate of brucellosis in Iran was 21.78 (95% CI: 21.66, 21.91). The majority of patients (58.84%) were male and 25-29 yr old. The first three provinces with the highest incidence rate of brucellosis included the following; Kurdistan (71.39 per 100000), Lorestan (68.09 per 100000) and Hamadan (56.24 per 100000). Brucellosis was more common in males, 25-29 aged yr, western provinces and spring months. The disease had a decreasing trend in the last years. MARS model was more appropriate rather than data mining models for prediction of monthly incidence rate of brucellosis.

Cohort profile: Famenin Brucellosis Cohort Study.

To achieve preventive and controlling activities of Brucellosis, we aimed this study as the first prospective cohort survey on brucellosis in Iran. This cohort in different phases from 2016 until 2020 going to investigate about brucella infection in selected population of Famenin, a city located in Hamadan province, west of Iran. A prospective cohort study. At the first phase of study, Famenin inhabitants including urban and rural people were studied during September to December in 2016. All identified household's people referred to specified health centers and clinically visited. Blood sampling was done, then these subjects were joined and the follow-up was initiated. At the next step, taken blood samples were examined using Wright kits and 2ME test for diagnosis the seroprevalence of brucellosis. Participants will be followed up for next years to examine clinical profiles of brucellosis and complete investigation about the main risk factors to reach strategies to control and reduce human and animal brucellosis. In the first phase, according to statistical analysis, 3363 persons including 47clusters were enrolled and considered for future studies. All participants were interviewed and demographic questioners were successfully completed. Finally, 2367 blood samples were entered in serology analysis. The seroprevalence of brucellosis based on serologic titers of Wright and 2ME test was 6.59% (95% CI: 5.62%: 7.66%) and 3.46 %( 95% CI: 2.72%: 4.20%) respectively. In the first phase, an extensive range of data and information were collected as the basic data for following phases of the cohort.

Prediction of the Omp16 Epitopes for the Development of an Epitope-based Vaccine Against Brucellosis.

Brucellosis is an infectious disease caused by Brucella bacteria that cause disease in animals and humans. Brucellosis is one of the most common zoonotic diseases transmitted from animals-to-human through direct contact with infected animals and also consumption of unpasteurized dairy products. Due to the wide incidence of brucellosis in Iran and economical costs in industrial animal husbandry, Vaccination is the best way to prevent this disease. All of the available commercial vaccines against brucellosis are derived from live attenuated strains of Brucella but because of the disadvantage of live attenuated vaccines, protective subunit vaccine against Brucella may be a good candidate for the production of new recombinant vaccines based on Brucella Outer Membrane Protein (OMP) antigens. In the present study, comprehensive bioinformatics analysis has been conducted on prediction software to predict T and B cell epitopes, the secondary and tertiary structures and antigenicity of Omp16 antigen and the validation of used software confirmed by experimental results. The final epitope prediction results have proposed that the three epitopes were predicted for the Omp16 protein with antigenicity ability. We hypothesized that these epitopes likely have the protective capacity to stimulate both the B-cell and T-cell mediated immune responses and so may be effective as an immunogenic candidate for the development of an epitope-based vaccine against brucellosis.

Frequency and Clinical Manifestations of Pediatric Brucellosis in Iran: A Systematic Review

Background Brucellosis is a zoonotic disease that is widely distributed throughout the developing countries. Children are considered as at risk groups for infection. The aim of this study was to assess the frequency and clinical manifestations of Brucellosis in Iranian children and adolescents. Materials and Methods: We systematically searched international databases; ISI, Medline (via PubMed), Scopus, and national databases Irandoc, Barakat knowledge network system, Magiran, and Scientific Information Database (SID). The search strategy was developed based on main terms of Brucellosis, Brucella fever, Gibraltar, Rock Fever, Undulant Fever, Cyprus Fever, Malta Fever, and Bang Disease. Results: A total of 885 studies were identified, from them a total of 12 studies that were conducted between 2001 and 2016 were included. Following the relevancy assessments and quality control, data from the 1,429 participants were presented in our review. The age of the patients ranged from 2 to 18 years. Only one out of twelve studies provided the prevalence of 4.30% and 3.4 incidence. Studies varied greatly in reporting high risk behavior of animal contact (8.4 to76.0%) and unpasteurized dairy (22.4 to 91.6%). Conclusion Our finding reveals the disparity of reported prevalence and clinical manifestations of Brucellosis in Iranian children. Fever and joint pain were the most frequent reported signs. Differences in study design, measurement tools and methods, and sub population sampling, does not provide the possibility of aggregation of data for more comprehensive inference.

Extraction and characterisation of Brucella abortus strain RB51 rough lipopolysaccharide

Brucellosis is an important zoonotic disease with considerable impacts on human and animal health. Brucella abortus strain RB51 vaccine is used for prevention of bovine brucellosis in Iran. Due to strain roughness, available serological tests cannot detect vaccinated animals. Detection of serological responses to the vaccine is important to monitor accurate vaccination implementation. Rough lipopolysaccharide (RLPS) of RB51 strain was extracted and characterised to develop serological tests for diagnosis of vaccinated animals. RLPS was extracted using phenol-chloroform-petroleum ether and evaluated by limulus amebocyte lysate (LAL) assay, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and agar gel immunodiffusion (AGID). According to our results, the extracted RLPS caused positive reaction in LAL assay. In SDS-PAGE, a band with a molecular weight around 14 kDa was identified after specific staining using silver nitrate. Double AGID of the RLPS with a hyperimmune serum resulted in a precipitation line formation. Our study showed that the method can be successfully used to extract RLPS from Brucella abortus strain RB51 as confirmed by LAL assay, PAGE and AGID.

A review of Brucellosis in Iran: Epidemiology, Risk Factors, Diagnosis, Control, and Prevention

Brucellosis caused by species of Brucella is among the most prevalent zoonoses with the annual incidence of half a million cases globally. Most parts of Iran are endemic for brucellosis, and the annual incidence of the human and animal brucellosis is still high. At present, there is no safe and protective human vaccine against brucellosis, and the only preventive strategy is animal vaccination, which harbors significant disadvantages. Considering the identification of many immunogenic proteins in Brucella, several studies have recently been performed to evaluate the vaccine potency of such antigens as a new subunit vaccine candidate. This review represents an overview of brucellosis in Iran, including epidemiology, transmission routs, diagnosis, and treatment. Moreover, it mainly highlights the history of brucellosis control and prevention in Iran, including eradication programs, vast livestock vaccination programs, and subunit vaccine studies. It also discusses major problems that the country encounters with disease control. In recent years, Persian scientists have focused on evaluating the efficacy of best Brucella immunogens in vivo to introduce a new subunit vaccine. The results of some studies could demonstrate the vaccine potential of some immunogens.

Epidemiology of brucellosis in Iran: A comprehensive systematic review and meta-analysis study.

Brucellosis is still one of the most challenging issues for health and the economy in many developing countries such as Iran. Considering the high prevalence of brucellosis, the aim of the current study was to systematically review published data about the annual incidence rate of this infection from different parts of Iran and provide an overall relative frequency (RF) for Iran using meta-analysis. We searched several databases including PubMed, ISI Web of Science, Scopus, google scholar, IranMedex and Iranian Scientific Information Database (SID) by using the following keywords: "Brucella", "Brucellosis", "Malta fever", "Mediterranean fever", "undulant fever", "zoonosis" and "Iran" in Title/Abstract/Keywords fields. Articles/Abstracts, which used clinical specimens and reported the incidence of brucellosis, were included in this review. Quality of studies was assessed by STROB and PRISMA forms. All statistical analyses were performed using STATA 11.0 (STATA Corp, College Station, TX) and P-values under 0.05 were considered statistically significant. Out of the 8326 results, we found 34 articles suitable, according to inclusion and exlusion criteria, for inclusion in this systematic review and meta-analysis. The pooled incidence of brucellosis was estimated 0.001% (95% confidence interval (CI)=0.0005-0.0015%) annually. Relative frequency of brucellosis in different studies varied from 7.0/100000 to 276.41/100000 in Qom and Kermanshah provinces, respectively. This systematic-review and meta-analysis study showed that the highest incidences of brucellosis are occurred in west and northwest regions of Iran. Totally, the incidence of the disease in Iran is in the high range.

Spatial and spatio-temporal analysis of human brucellosis in Iran.

Brucellosis is an important public and veterinary health problem in Iran and poses enormous economic burdens and significant human morbidity. In order to better understand the epidemiology of the disease in Iran, yearly spatial distribution and possible hotspots of the disease have been investigated in this study. A cross-sectional survey was performed on 39 359 recorded cases during April 2009 to March 2012 throughout the country. Moran's I was applied to investigate the yearly patterns of the spatial distribution. Presence of possible hotspots was investigated using both local Moran's I and spatial and space-time scan statistics. Moran's I at county and province level showed that distribution of human brucellosis was regularly clustered. Both local Moran's I and spatial and space-time scan statistics detected significant hotspots of human brucellosis cases with high incidence rates. Hotspots were predominantly located in the west, northwest and northeast. Comparison of the population-based frequencies of human brucellosis in different elevation classes indicated the highest possibility of human brucellosis occurred in counties with high average altitudes (>2000 m). Human brucellosis continues to be a widespread challenge, especially in western and northwestern parts of Iran. The hotspots highlight the potential high risk areas requiring special plans and resources for monitoring and control of the disease.