Sero-prevalence of Bovine Brucellosis and associated risk factors in mbeya region, Southern highlands of Tanzania

Effect of awareness training to frontline health workers and the use of e-based technology on reporting of brucellosis cases in selected pastoral communities, Tanzania: a quasi-experimental study

INTRODUCTION

Brucellosis is a serious community health problem and endemic disease in Tanzania in both humans and animals. Frontline health workers (FHWs) play a vital role in reporting and hence prevent and control brucellosis in rural settings. This study aims to evaluate the effect of awareness training to frontline health workers and use of electronic technology (e- technology) on reporting of brucellosis cases.

METHODS

A quasi-experimental design was implemented in two pastoral communities in eastern part of Tanzania with one as control and another as treatment involving 64 FHWs who were purposively selected from May 2020 to December 2020. A total of 32 FHWs from treatment pastoral community were purposively selected for awareness training, rapid diagnosis using Rose Bengal test (RBT) and use of electronic technology (AfyaData app) for brucellosis reporting while nothing was done in control community. Before and after training information about their knowledge, attitude and practices were collected from all participants using a structured questionnaires uploaded in the mobile phone powered by AfyaData application. Blood samples were collected from 141 febrile patients attending the selected facilities in treatment community. Serum obtained from collected blood were analyzed using RBT and Competitive Enzyme Linked Immunosorbent Assay (c-ELISA) for brucellosis screening and confirmatory, respectively. Results from this analysis were reported back to the health facility using AfyaData app. Chi-square was used to analyze categorical variables and t-test and/Anova test was used to assess the effectiveness of the intervention.

RESULTS

Results revealed that before the training majority of the participants were ignorant about brucellosis, although they had good attitude towards brucellosis prevention. Participant's awareness, practice and attitude increased significantly (p = 0.003, p = 0.001, p = 0.032) respectively, after the intervention. Total of 17(12.1%) patients were positive on RBT and four (2.8%) were confirmed by c-ELISA. AfyaData app was proven to provide quick reports regarding brucellosis in the study area.

CONCLUSION

The training program was effective in increasing the level of knowledge and practice about brucellosis. Electronic based technology (AfyaData app) improved the reporting of brucellosis cases. There is a need for the use of electronic based technology to improve timely management of brucellosis in pastoral communities. Also, continuous training on FHWs regarding the disease is needed to improved their awareness and practices.

Herd and animal level seroprevalence and associated risk factors of bovine brucellosis in different agro-ecologies of southwest Ethiopia

Brucellosis is a zoonotic infection that commonly affects cattle in Ethiopia, causing significant negative economic impact. A cross-sectional study was carried out between November 2020 and November 2021 in southwest Ethiopia to determine the seroprevalence of brucellosis and its associated risk factors in cattle herds. Blood samples were taken from 461 randomly selected cattle to test for the presence of Brucella antibodies using the Rose Bengal Plate test, with positive serum confirmed through the complement fixation test. A multivariable random effect logistic regression analysis was used to identify potential risk factors for Brucella seropositivity. The study found 7.14% (95% CI: 4.44-9.01) seroprevalence at the animal level and 12.23% (95% CI: 6.52-16.05) at the herd level based on the complement fixation test. Age (OR = 6.9, 95%CI: 1.83-15.97), herd size (OR = 3.66, 95%CI: 1.39-9.61), introducing new animals (OR = 2.72, 95%CI: 1.17-6.29), management system (OR = 12.2, 95%CI: 1.53-26.80), species composition (OR = 4.24, 95%CI: 1.51-11.91), and abortion (OR = 7.1, 95%CI: 1.93-15.39) were found to be associated with Brucella seropositivity. The analysis also revealed two risk factors for Brucella infection at the herd level, including herd size (OR = 3.4, 95% CI: 1.05-10.68) and species composition (OR = 3.1, 95% CI: 1.20-7.88). The presence of Brucella antibodies in cattle highlights the need for increased awareness and measures to mitigate the identified risk factors of the disease to prevent its spread. Furthermore, further studies are necessary to investigate the zoonotic transmission of brucellosis to humans and its role in cattle reproduction disorders in the study area.

The Status and Risk Factors of Brucellosis in Smallholder Dairy Cattle in Selected Regions of Tanzania

Bovine brucellosis is a bacterial zoonoses caused by Brucella abortus. We conducted a cross-sectional study to determine brucellosis seroprevalence and risk factors among smallholder dairy cattle across six regions in Tanzania. We sampled 2048 dairy cattle on 1374 farms between July 2019 and October 2020. Sera were tested for the presence of anti-Brucella antibodies using a competitive enzyme-linked immunosorbent assay. Seroprevalence was calculated at different administrative scales, and spatial tests were used to detect disease hotspots. A generalized mixed-effects regression model was built to explore the relationships among Brucella serostatus, animals, and farm management factors. Seroprevalence was 2.39% (49/2048 cattle, 95% CI 1.7-3.1) across the study area and the Njombe Region represented the highest percentage with 15.5% (95% CI 11.0-22.0). Moreover, hotspots were detected in the Njombe and Kilimanjaro Regions. Mixed-effects models showed that having goats (OR 3.02, 95% C 1.22-7.46) and abortion history (OR 4.91, 95% CI 1.43-16.9) were significant risk factors for brucellosis. Education of dairy farmers regarding the clinical signs, transmission routes, and control measures for brucellosis is advised. A One Health approach is required to study the role of small ruminants in cattle brucellosis and the status of brucellosis in dairy farmers in the Njombe and Kilimanjaro Regions.

Multisectoral cost analysis of a human and livestock anthrax outbreak in Songwe Region, Tanzania (December 2018-January 2019), using a novel Outbreak Costing Tool

OBJECTIVES

We applied a novel Outbreak Costing Tool (OCT), developed by the US Centers for Disease Control and Prevention (CDC), to estimate the costs of investigating and responding to an anthrax outbreak in Tanzania. We also evaluated the OCT's overall utility in its application to a multisectoral outbreak response.

METHODS

We collected data on direct costs associated with a human and animal anthrax outbreak in Songwe Region (December 2018 to January 2019) using structured questionnaires from key-informants. We performed a cost analysis by entering direct costs data into the OCT, grouped into seven cost categories: labor, office, travel and transport, communication, laboratory support, medical countermeasures, and consultancies.

RESULTS

The total cost for investigating and responding to this outbreak was estimated at 102,232 United States dollars (USD), with travel and transport identified as the highest cost category (62,536 USD) and communication and consultancies as the lowest, with no expenditure, for the combined human and animal health sectors.

CONCLUSIONS

Multisectoral investigation and response may become complex due to coordination challenges, thus allowing escalation of public health impacts. A standardized framework for collecting and analysing cost data is vital to understanding the nature of outbreaks, in anticipatory planning, in outbreak investigation and in reducing time to intervention. Pre-emptive use of the OCT will also reduce overall and specific (response period) intervention costs for the disease. Additional aggregation of the costs by government ministries, departments and tiers will improve the use of the tool to enhance sectoral budget planning for disease outbreaks in a multisectoral response.

Bovine Brucellosis in Gauteng, South Africa: Seroprevalence amongst Cattle Handlers and Variables Associated with Seropositive Cattle Herds, 2014-2016

In South Africa, the prevalence of cattle handler exposure to Brucella on cattle farms is unknown and risk factors and cattle symptoms associated with infected cattle herds are unavailable. To address this gap, a case-control study of cattle herds was conducted in Gauteng province and farm workers and veterinary officials were tested for exposure to Brucella. Seroprevalence amongst farm workers exposed to case herds ranged from 4.0% (BrucellaCapt®) to 16.7% (IgG ELISA®), compared to those exposed to control herds, where seroprevalence ranged from 1.9% (BrucellaCapt®) to 5.7% (IgG ELISA®). Seroprevalence amongst veterinary officials was significantly greater compared to farm workers exposed to case herds for the outcome RBT+ IgM- IgG+ (OR = 11.1, 95% CI: 2.5-49.9, p = 0.002) and RBT- IgM- IgG+ (OR = 6.3, 95% CI: 2.3-17.3, p < 0.001). Risk factors associated with being an infected herd were: being a government-sponsored farm vs. private farm (OR 4.0; 95% CI: 1.4-11.3; p = 0.009), beef vs. dairy herd (OR 7.9; 95% CI: 1.4-44.9; p = 0.020), open vs. closed herd (OR 3.3; 95% CI: 1.1-10.4; p = 0.038) and the presence of antelope on the farm (OR 29.4; 95% CI: 4.0-218.2; p = 0.001). Abortions (OR = 5.1; 95% CI: 2.0-13.3; p < 0.001), weak calves in the herd (OR = 8.0; 95% CI: 2.6-24.4; p < 0.001), reduction in number of calves born (OR = 9.0; 95% CI: 2.1-43.6; p < 0.001), reduction in conception rate (OR = 3.9; 95% CI: 0.8-18.3; p = 0.046), hygromas in cattle (p = 0.011) and farmers reporting brucellosis-like symptoms in their farm workers or in him/herself (OR = 3.4; 95% CI: 1.3-8.7; p = 0.006) were more likely to be associated with Brucella infected herds than control herds. This evidence can be used in strategic planning to protect both human and herd health.

Documenting the absence of bovine brucellosis in dairy cattle herds in the southern region of Malawi and the associated knowledge, attitudes and practices of farmers

There is paucity of Brucella prevalence data in Malawi. For this reason, a cross-sectional study was conducted, from 06 January 2020 to 27 February 2020, to estimate the seroprevalence of brucellosis in dairy cattle herds amongst smallholder farmers, government and private dairy farms in the southern region. A total of 529 serum samples were screened for anti-Brucella antibodies using the Rose Bengal test (RBT) and a competitive enzyme-linked immunosorbent assay (cELISA). A pre-tested electronic (Epicollect tool, Wellcome Sanger Institute, United Kingdom) questionnaire was administered to 378 smallholder farmers to assess their knowledge, attitudes and practices towards brucellosis. Descriptive statistics were used to analyse the data in Microsoft Excel^® and Statistical Package for Social Sciences (SPSS^®) version 21. No animal tested positive for presence of anti-Brucella antibodies, indicating 0% prevalence (individual and herd levels). The majority (94.2%; 95% confidence interval [CI]: 91.8–96.5) of smallholder farmers had never heard about brucellosis. Furthermore, assisting during parturition without protective equipment (41.3%; 95% CI: 36.3–46.2) and using bulls for breeding (75%; 95% CI: 70.2–78.9) were amongst the common risk practices that were identified. We could not detect brucellosis in this study that indicates the disease could be very rare or even absent in the dairy cattle herds of the southern region of Malawi. However, further Brucella studies need to be conducted in cattle, small livestock, wildlife and humans to document the true status of brucellosis in the country. Brucellosis surveillance, monitoring, awareness and preventive measures are required to maintain this favourable situation.

Sero-prevalence and risk factors of Brucella presence in farm bulk milk from open and zero grazing cattle production systems in Rwanda

BACKGROUND

Animal and human brucelloses have been reported in Rwanda, human brucellosis being linked to drinking inadequately heat-treated milk. However, information on Brucella detection and prevalence in milk produced in Rwanda is limited.

OBJECTIVES

To determine the sero-prevalence and risk factors of Brucella in farm bulk milk from zero and open grazing cattle production systems in Rwanda.

METHODS

A total of 330 farm bulk milk samples were collected from 198 zero grazing farms and 132 open grazing farms in a cross-sectional study in Rwanda. Sero-prevalence of Brucella in milk was analysed using indirect enzyme-linked immunosorbent assay. A questionnaire was administered to farmers to determine the risk factors of milk contamination with Brucella.

RESULTS

Anti-Brucella antibodies were prevalent in 19.7% (95% confidence interval (CI), 15.5-24.4) of the 330 collected farm bulk milk. Sero-prevalence was significantly higher (p < 0.05) in open grazing farms (37.9% [50/132]) than in zero grazing farms (7.6% [15/198]). Practising open grazing system (odds ratio, OR = 69.5; 95% CI = 1.6-3033.6), history of abortion (OR = 19.5; 95% CI = 8.1-46.8) and placenta retention (OR = 4.2; 95% CI = 1.7-10.3) were the significant risk factors for the presence of anti-Brucella antibodies in milk.

CONCLUSION

Notably, more than a third of farm bulk milk from open grazing farms in Rwanda contains Brucella antibodies. Considering the zoonotic nature of Brucella, there is a need to reinforce brucellosis control programs in the country.

Quantitative evaluation of the infection dynamics of bovine brucellosis in Tanzania

Brucellosis is endemic in Tanzania. A cross-sectional study was conducted at 17 cattle farms in agro-pastoral areas in Tanzania to identify risk factors associated with the within-farm prevalence of bovine brucellosis and to quantitatively assess the infection dynamics through disease modelling. Cattle blood sampling and interviews with farmers using a structured questionnaire were conducted. A total of 673 serum samples were screened using the Rose-Bengal plate test (RBPT), and sero-positivity of RBPT-positive samples was confirmed using a competitive enzyme-linked immunosorbent assay. Zero-inflated binomial regression was performed for univariable and multivariable risk factor analyses of within-farm prevalence. Several susceptible-infectious (SI) models were compared based on deviance information criteria, and age-dependent force of infection (FOI) was measured using age-specific prevalence data for the 10 infection-positive farms. Using the diagnoses of cows on the 17 farms, the basic reproduction number, R₀, was also calculated. The farm-level prevalence and animal-level adjusted prevalence were 58.8 % (10/17, 95 % confidence interval: 33.5-80.6 %) and 7.0 % (28/673, 95 % credible interval: 5.7-8.4 %), respectively. The risk factor for high within-farm prevalence was introduction of cattle from other herds. A mathematical model with constant FOI showed the annual probability of infection as 1.4 % (95 % credible interval: 1.0 %-2.0 %). The R₀ was 1.07. The constant FOI could have been due to the predominant mode of infection being transmission of Brucella from contaminated aborted materials during grazing. Direct purchase of infected cattle could facilitate efficient transmission between susceptible animals through abortion.

Brucellosis and its associated risk factors to humans and domestic ruminants in Kagera Ecosystem, Tanzania

BACKGROUND

Brucellosis is an important disease for both veterinary and public health. A study was conducted to understand the seroprevalence of brucellosis and its associated risk factors in pastoral areas of Kagera, Tanzania.

METHODS

Sera from 156 patients with malaria-like symptoms were analyzed using the commercial rapid agglutination test (specific for B.abortus and B.melitensis detection) and Fluorescence Polarization Assay (FPA). Sera from 426 cattle, 206 goats and 197 sheep were analyzed using Rose Bengal Plate (RBPT) and Competitive ELISA (c-ELISA) tests.

RESULTS

In humans, overall brucellosis, B. abortus, and B. melitensis sero-prevalences were 7.7% (95%CI: 3.8-12.2%), 1.9% (95% CI: 0.4-4.5%), and 5.8 % (95%CI: 2.6-10.6%), respectively. At animal level, seropositivity was 5.9% (95%CI: 4.0-8.6%), 2.5% (95%CI: 0.8-5.7%) and 0.5% (95%CI: 0.01-2.8%) in cattle, goats and sheep, respectively. At herd level, seropositivity was 18.2% (95%CI: 12.0-25.8%) in cattle and 6.9% (95%CI: 2.2-15.3%) in small ruminants. Brucellosis was associated with assisting in parturition without wearing protective gears (OR= 5.6; p= 0.02) in humans, herds of 50-200 animals (OR= 4.2, p= 0.01) and cattle (OR=3.5; p=0.01). The knowledge of brucellosis among pastoralists (OR=0.1; p<0.01) was a protective factor.

CONCLUSION

Brucella infections could be occurring in pastoralists and domestic ruminants in Kagera. Community health education is necessary for the control of brucellosis in Tanzania.

Brucellosis: Prevalence with reference to East African community countries - A rapid review

Brucellosis is a zoonotic disease which is endemic to certain regions of the world including Sub-Saharan Africa. The aim of this article is to provide a recent and rapid review on brucellosis prevalence in East African Community (EAC) countries. Literature was obtained using Google Scholar search engine and screened for relevancy and fulfilment of criteria to 1, 17, 4, 4, 30 and 29 articles retained for brucellosis prevalence in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Recent literature (published in the last decade 2010 to 2019) was considered for prevalence results in this review. In EAC, livestock had an animal-level prevalence of 0.2% to 43.8%, 0.0% to 20.0% and 0.0% to 13.8% for cattle, goats and sheep respectively. In humans, the prevalence varied mostly between 0.0% and 35.8%. In conclusion, brucellosis is quite prevalent in the region. The reported prevalence calls for plans or more efforts from individual member countries and from EAC, as a region, to control brucellosis.

Seroprevalence and Risk Factors of Brucella Infection in Dairy Animals in Urban and Rural Areas of Bihar and Assam, India

This study assessed seropositivity of Brucella infection in dairy animals and risk factors associated with it. The cross-sectional study used multi-stage, random sampling in the states of Bihar and Assam in India. In total, 740 dairy animals belonging to 534 households of 52 villages were covered under this study. Serological testing was conducted by indirect enzyme-linked immunosorbent assay (iELISA). Animal-level Brucella seropositivity was found to be 15.9% in Assam and 0.3% in Bihar. Seropositivity in urban areas (18.7%) of Assam was found to be higher than in rural areas (12.4%). Bihar was excluded from the risk factor analysis, as only one Brucella seropositive sample was detected in the state. A total of 30 variables were studied for assessing risk factors, of which 15 were selected for multivariable regression analyses following a systematic process. Finally, only three risk factors were identified as statistically significant. It was found that animals belonging to districts having smaller-sized herds were less likely (p < 0.001) to be Brucella seropositive than animals belonging to districts having larger-sized herds. Furthermore, the chance of being Brucella seropositive increased (p = 0.007) with the increase in age of dairy animals, but decreased (p = 0.072) with the adoption of artificial insemination (AI) for breeding. We speculated that the identified risk factors in Assam likely explained the reason behind lower Brucella seropositivity in Bihar, and therefore any future brucellosis control program should focus on addressing these risk factors.

Seroprevalence of Bovine Brucellosis in Selected Districts of Zambia

Brucellosis is an infectious zoonosis that has huge economic and public health implications globally. The disease is prevalent in humans, livestock and wildlife in Sub-Saharan Africa. A cross-sectional study was conducted between 6 May 2017 and 31 July 2020 during which 1712 sera from 175 cattle herds in five districts from Southern, Western and Eastern Provinces of Zambia were collected and screened against brucellosis. The Rose Bengal Test (RBT) and competitive Enzyme-linked Immuno Assay (c-ELISA) were used in serial testing for the detection of antibodies against Brucella species. A total of 127 animals from 37 herds tested positive, giving overall individual animal and herd-level seroprevalences of 7.53% (95% CI: 6.28–8.78%) and 21.14% (95% CI: 15.0–27.2%), respectively. Namwala district had the highest herd seroprevalence (33.9%, 95% CI: 21.6–46.1%), while Lundazi did not record any seropositivity. Comparably, Southern Province had the highest individual animal (8.97%, 95% CI: 7–11%) and herd-level (28.5%, 95% CI: 20.3–36.7%) seroprevalences, although this was not statistically significant. Within Southern Province, higher seropositivity was observed in Namwala district (OR: 8.55; CI: 2.66–27.44), among female animals (OR: 2.48; CI: 1.38–4.46) and in those aged 11 years and above (OR: 2.67; CI: 1.34–5.34) as well as in gravid cows (OR: 4.34; CI: 2.08–8.92). Seropositivity was also observed among some animals with hygromas (OR: 6.5; CI: 0.45–94.08) and those with a history of abortion (OR: 1.13; CI: 0.18–7.28) although the findings were not statistically significant. Brucella seroprevalence among traditional cattle in Zambia remains high. Control programs against bovine brucellosis must be introduced to reduce its impact on human health and animal production.

Seroprevalence and Associated Risk Factors of Bovine Brucellosis at the Wildlife-Livestock-Human Interface in Rwanda

Bovine brucellosis is endemic in Rwanda; however, little information is available on seroprevalence and risk factors. Therefore, a cross-sectional study was conducted among cattle farmed at the wildlife-livestock-human interface (n = 1691) in five districts and one peri-urban district (n = 216). Cattle were screened using the Rose Bengal test, then the results were confirmed by indirect enzyme-linked immunesorbent assay. Potential risk factors were determined with a questionnaire and analyzed for their association with seropositivity. In all districts, the animal and herd-level seroprevalence was 7.4% (141/1907) and 28.9% (61/212), respectively, 8.3% (141/1691) and 30.9% (61/198) at the interface, and 0.0% (0/216) in peri-urban areas. Among the potential risk factors, old age (≥5 years), cattle farmed close to wildlife, herds of cattle and small ruminants, history of abortions, and replacement animals were significantly associated with brucellosis (p < 0.05). Low awareness of zoonotic brucellosis, assisting calving without biosafety protection, drinking raw milk, and manual milking were each observed in more than 21.7% of cattle keepers whose herds were seropositive. This study confirmed brucellosis endemicity in cattle farmed close to wildlife in Rwanda, suggesting the need to focus control efforts in these areas. Educated farmers with a high awareness of zoonotic brucellosis had low bovine brucellosis seropositivity, which emphasizes the importance of education.

Association of brucellosis to abortions in humans and domestic ruminants in Kagera ecosystem, Tanzania

Brucellosis is a worldwide zoonotic disease of socio-economic importance. Understanding the association of this disease with pregnancy outcome has the potential of contributing to the reduction of its reproductive burden in humans and animals among pastoral communities in Tanzania. A prospective cohort study was conducted in Kagera Region on pregnant women (n = 76) and gravid ruminants (121 cattle, 125 goats and 111 sheep). Exposed and non-exposed groups to brucellosis were followed for 6 months (from 15 November 2017 to 15 April 2018). Sera were collected and analysed using Rose Bengal Test (RBT) and Fluorescence polarization assay (FPA) test. Measures of effect, univariable and multivariable logistic regression analyses were computed. Positivity to both RBT and FPA tests was 21% (95% CI: 12.5-32) in pregnant women and 5% (95% CI: 3.1-8) in gravid ruminants. Among aborted cases, four women (out of nine), two cows (out of seven), two goats (out of 26) and zero sheep (out of 11) were positive to brucellosis. The abortion rate in humans and ruminants was 11.8% and 12.3%, respectively. Seropositivity to brucellosis was similar in aborted and non-aborted cases in humans (p = .08) and in ruminants (p = .2). At the population level, brucellosis was associated with abortions (population attributable risk: PAR) at 3.5% in pregnant women and at 0.5% in gravid ruminants in the study area. Infections to brucellosis were increased in exposed pregnant women (OR = 19; 95% CI: 1.8-203, p = .01) and in cattle (OR = 11; 95% CI: 1.3-88, p = .02). There is an indication that brucellosis could be contributing to abortions in pregnant women and domestic ruminants Kagera Region. Molecular tools could support more the results from serological tests to avoid cross-reaction with other pathogen agents. Control of brucellosis in animals is likely to reduce the threat of abortions in humans.

Status and influencing factors of farmers' private investment in the prevention and control of sheep brucellosis in China: A cross-sectional study

Background

Brucellosis is one of the most common zoonoses worldwide, causing direct losses to the livestock industry and threatening human health. Little is known about the status and factors affecting farmers’ private investment in the prevention and control of sheep brucellosis in China.

Methodology/Principal findings

From April to October 2017, a cross-sectional, house-based study was conducted in 7 Chinese provinces. A total of 1037 households included in the study were analyzed. The average amount of private investment in the prevention and control of brucellosis was $0.73±0.54 per sheep. Multivariable analysis showed that factors facilitating private investment included older age of householder (OR = 1.07, 95%CI: 1.03–1.11), herd size >100 (OR = 2.49, 95%CI: 1.38–4.51), a higher percentage of income from sheep farming comparing to the total household income (OR = 1.14, 95%CI: 1.11–1.16), higher score of brucellosis knowledge (OR = 3.85, 95%CI: 1.40–10.51), actively learning related knowledge (OR = 2.98, 95%CI: 1.55–5.74), actively participating in related training courses (OR = 3.07, 95%CI: 1.52–6.18), care about other people’s attitudes (OR = 1.75, 95%CI: 1.35–2.28), concern about the health of neighbors’ livestock (OR = 1.75, 95%CI: 1.23–2.51). The analysis found a discouraging factor for private investment, supporting culling policy (OR = 0.67, 95%CI: 0.49–0.91).

Conclusions/Significance

In addition to providing interventions related to farmers’ knowledge, attitudes and practices, guidance must be offered to help farmers understanding the importance of private investment in the prevention and control of brucellosis.

Brucellosis is one of the most common zoonoses worldwide. The disease is endemic in China and the prevention and control of brucellosis mainly depends on government investment. From the perspective of economic theory, private investment can help supplement public investment. Thus, it is important to describe the status of farmers’ private investment in brucellosis prevention and control in epidemic areas and to explore the factors influencing this investment.