Methodological choices in brucellosis burden of disease assessments: A systematic review

A systematic review of the methodological considerations in Campylobacter burden of disease studies

BACKGROUND

Campylobacteriosis is a major zoonotic and foodborne disease (FBD), posing a substantial social and health economic burden on human health. Burden of disease (BoD) studies, which increasingly use the disability-adjusted life years (DALYs) metric, provide comprehensive insights into disease effects. However, the complexity of DALY calculations, combined with diverse causative agents and research gaps, complicates cross-regional comparisons. This review evaluates existing Campylobacter BoD studies and interrogates their methodological approaches and assumptions in quantifying DALYs.

METHODS/PRINCIPAL FINDINGS

A systematic search of PubMed, EMBASE, Web of Science, and selected grey literature databases was conducted to identify existing Campylobacter BoD studies. Studies assessing the BoD methodology and calculation using the DALY framework were considered. In total, 23 studies met the predefined inclusion criteria. Of these, 19 were single-country studies, while 4 were multi-country analyses. A significant data gap exists, with limited or no studies from low- and middle-income countries (LMICs), exemplified by just one study obtained from Rwanda. Most studies used an incidence- and pathogen-based approach to estimate DALYs, excluding social weighting, in line with the Global Burden of Disease (GBD) study. Methodological discrepancies were noted, especially in disability weight (DW) assignment, health state classification, and life expectancy table usage. Most single-country studies (n=8) used national life tables rather than universal ones, challenging cross-country comparisons due to a lack of standardisation.

CONCLUSION

Significant variations in the methodological approaches and assumptions for Campylobacter BoD studies exist. Addressing these disparities is essential for harmonising methodological design choices using the DALYs metric to inform evidence-based public health policies and interventions.

PROSPERO REGISTRATION NUMBER

The protocol for this study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), which can be accessed under the registration number CRD42023414973.

Disease burden of brucellosis among the elderly in Inner Mongolia, China: A cross-sectional data study from 2016 to 2020

Brucellosis is a zoonotic infection with an annually increasing incidence in the elderly. However, few research teams studied the brucellosis disease burden on this elderly population. This study assesses the brucellosis disease burden of elderly patients in Inner Mongolia, to explore its influencing factors, and provide a scientific basis for effectively reducing the disease burden in this demographic. This study described the disease burden of brucellosis in the elderly population in Inner Mongolia from 2016 to 2020. The incidence of brucellosis among the elderly showed an annually increasing trend, with concentrated incidences from April to July each year. The male and 60-69 age groups exhibit a high prevalence of brucellosis, while Xilingol, Ulanqab, and Hohhot exhibited high disease burdens. Meanwhile, Bayannur exhibited the fastest disease burden growth. Precipitation and the value of total pastoral production were positively correlated with the disease burden. In contrast, the sunshine duration, the number of health institutions, and GDP per capita exhibited negative correlations with the disease burden. The growing brucellosis incidence and disease burden among the elderly in Inner Mongolia is a serious issue. Relevant departments and agencies should focus on protecting the male population aged 60 to 69. Continuous attention should be directed to the western regions to prevent the emergence of new high-risk areas. Strengthening the rural healthcare system through increased medical personnel and financial investment is crucial to lowering the risk of brucellosis and alleviating its impact on the elderly population.

A framework for quantifying the multisectoral burden of animal disease to support decision making

Animal diseases have wide-ranging impacts in multiple societal arenas, including agriculture, public health and the environment. These diseases cause significant economic losses for farmers, disrupt food security and present zoonotic risks to human populations. Additionally, they contribute to antimicrobial resistance and a range of environmental issues such as greenhouse gas emissions. The societal and ecological costs of livestock diseases are frequently underrepresented or unaddressed in policy decisions and resource allocations. Social cost-benefit analysis (SCBA) offers a comprehensive framework to evaluate the broad impacts of animal diseases across different sectors. This approach aligns with the One Health concept, which seeks to integrate and optimize the health of humans, animals and the environment. Traditional economic evaluations often focus narrowly on profit maximization within the livestock sector, neglecting wider externalities such as public health and environmental impacts. In contrast, SCBA takes a multi-sectoral whole-system view, considering multiple factors to guide public and private sector investments toward maximizing societal benefits. This paper discusses three separate sector specific (Animal health, Human health, Environmental health) methodologies for quantifying the burden of animal diseases. It then discusses how these estimates can be combined to generate multisectoral estimates of the impacts of animal diseases on human societies and the environment using monetary values. Finally this paper explores how this framework can support the evaluation of interventions from a One Health perspective though SCBA. This integrated assessment framework supports informed decision-making and resource allocation, ultimately contributing to improved public health outcomes, enhanced animal welfare, and greater environmental sustainability.

"I'm Not Who I Used to Be!" The Compelled Metamorphosing Process of Coping with Brucellosis Among Chinese Patients: A Qualitative Study

BACKGROUND

Brucellosis, one of the most common zoonotic diseases globally, is a serious public health problem. The complex and diverse clinical manifestations pose numerous challenges for patients when coping with brucellosis. Scarce studies have been performed in China.

OBJECTIVES

This study aimed to explore the process of coping with brucellosis and different aspects of the phenomenon from the perspective of patients, and propose a conceptual framework of patients' processes in coping with brucellosis.

METHODS

Qualitative study based on constructivist grounded theory methodology using in-depth interviews and focus group discussions. The data analysis included initial coding, focused coding, and theoretical coding using the constant comparative method and memo writing.

RESULTS

The conceptual framework of "compelled metamorphosing" was constructed, which conceptualized three primary types of coping strategies: "blind persistence", "resignation to avoidance", and "proactive pacing". Symptoms, financial strain, information cocoon, emotional value, and family responsibility had an important impact on coping strategies and played a significant role in driving their development.

CONCLUSIONS

This paper provides new insight into patients' lives and describes the strategies patients use to cope with the challenges and problems caused by brucellosis. Compelled metamorphosing represents a basic psychosocial process. These findings can be used to develop future complex interventions and studies.

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.