Review of Brucellosis in Nepal

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.

Epidemic Situation of Brucellosis in Jinzhou City of China and Prediction Using the ARIMA Model

Objective

This study aimed to investigate the specific epidemiological characteristics and epidemic situation of brucellosis in Jinzhou City of China so as to establish a suitable prediction model potentially applied as a decision-supportive tool for reasonably assigning health interventions and health delivery.

Methods

Monthly morbidity data from 2004 to 2013 were selected to construct the autoregressive integrated moving average (ARIMA) model using SPSS 13.0 software. Moreover, stability analysis and sequence tranquilization, model recognition, parameter test, and model diagnostic were also carried out. Finally, the fitting and prediction accuracy of the ARIMA model were evaluated using the monthly morbidity data in 2014.

Results

A total of 3078 cases affected by brucellosis were reported from January 1998 to December 2015 in Jinzhou City. The incidence of brucellosis had shown a fluctuating growth gradually. Moreover, the ARIMA(1,1,1)(0,1,1)₁₂ model was finally selected among quite a few plausible ARIMA models based upon the parameter test, correlation analysis, and Box-Ljung test. Notably, the incidence from 2005 to 2014 forecasted using this ARIMA model fitted well with the actual incidence data. Notably, the actual morbidity in 2014 fell within the scope of 95% confidence limit of values predicted by the ARIMA(1,1,1)(0,1,1)₁₂ model, with the absolute error between the predicted and the actual values in 2014 ranging from 0.02 to 0.74. Meanwhile, the MAPE was 19.83%.

Conclusion

It is suitable to predict the incidence of brucellosis in Jinzhou City of China using the ARIMA(1,1,1)(0,1,1)₁₂ model.

Awareness and Practices Relating to Zoonotic Diseases Among Smallholder Farmers in Nepal

Increasing livestock production to meet growing demands has resulted in greater interactions at the livestock-wildlife-human interface and more opportunities for zoonotic disease spread. Zoonoses impose enormous burdens on low-income countries like Nepal, where populations are largely dependent on livestock production and access to shared grazing lands, often near protected areas, due to population pressures. Several livestock-associated zoonoses have been reported in Nepal; however, little is known regarding Nepali farmers' knowledge of zoonoses and opportunities for disease management. We conducted a cross-sectional study to investigate Nepali farmers' awareness of zoonoses, assess current health challenges, and evaluate disease prevention and control practices. We found that awareness of zoonotic pathogens was limited, especially in informally educated and illiterate farmers; the majority of which were women. Further, farmers' preventive herd health, food safety, and sanitation practices were not associated with their awareness. Several farmers reported high-risk practices despite being aware of zoonotic diseases, suggesting a disconnect between the farmers' awareness and practice. Our study highlights the need for improving Nepali farmers' knowledge of zoonoses and disease prevention measures. Closing these awareness-practice gaps will require an improved understanding of risk and effective drivers of behavior change, alongside engagement of farmers in development of zoonotic disease prevention programs that encourage participation of both male and female farmers across all levels of education.