Abstract
Brucellosis presents a major concern worldwide, especially for people living under resource-limited settings. Until this date, a reliable estimate of the global annual incidence has been elusive for human disease. In order to truly comprehend its burden, it is vital for the international community to recognize its distribution and frequency. To address this gap, we employ a novel approach in which available data from the World Organization of Animal Health (WOAH), World Bank, and the United Nations (UN) is used to estimate the annual number of newly infected people worldwide and regionally, utilizing risk metrics and at- risk populations. Estimates are developed based on three different models that utilize Bayesian inference, bootstrap resampling, and weighted average interpolation that take into consideration missing information, underreporting, inadequate diagnostic capacity, and diagnostic misclassification. Alarmingly, a conservative estimate of the annual global incidence is many times higher than the historical speculation. Incorporating diagnostic misclassification into the models expands the estimate to an alarming order of magnitude. As expected, the vast majority of the estimated cases are predominantly occurring within Africa and Asia. Nevertheless, although the magnitude of the burden is significantly lower in areas within the Americas and Europe, some of these regions are still a concern and should be closely monitored for potential disease reemergence. As human brucellosis is evidently neglected in the regions where the risk of disease is most prominent, its reinstatement as a priority Neglected Zoonotic Disease by the World Health Organization (WHO) should become urgent to curb the disease spread.
