Original Article

Incidence, Mortality, and Burden of Human Brucellosis and Its Geographical Distribution in Iran during 2009-2015


Background: Human brucellosis is the most common zoonotic disease worldwide. This study aimed at estimating the incidence, mortality, and burden of human brucellosis as well as its distribution in Iran from 2009 to 2015.

Methods: Disability Adjusted Life Years (DALYs) index was used to estimate the burden of human brucellosis. To calculate DALYs, years lost due to disability (YLDs) was added to years of life lost due to premature death (YLLs); they were calculated based on the Global Burden of Disease (GBD) formula recommended by the WHO. The data on incidence and mortality were collected from the national surveillance system of brucellosis disease in the Center for Communicable Diseases Control (CCDC), Ministry of Health and Medical Education (MOHME), expert panels, and related literature.

Results: There is an increasing trend in human brucellosis-related DALYs (34.6 per 100,000 in 2009, and 71.4 per 100,000 in 2015), incidence (88450 in 2009, and 198030 in 2015), and mortality (244 in 2009, and 578 in 2015) from 2009 to 2015. Human brucellosis-related DALYs, incidence, and mortality were higher among males than females. About 51% of DALYs was attributed to YLLs. The burden of human brucellosis disease was not equally distributed among all provinces of Iran and it was largely concentrated in a number of provinces.

Conclusion: Burden of human brucellosis is significantly high in Iran, and it has also increased during the recent years. It is alarming for health system managers and policymakers, and they are recommended to pay more attention to this issue.



1. Pappas G, Papadimitriou P, Akritidis N et al (2006). The new global map of human brucellosis. Lancet Infect Dis, 6(2):91-9.
2. Abu Shaqra QM (2000). Epidemiological aspects of brucellosis in Jordan. Eur J Epidemiol, 16(6):581-4.
3. Domingo AM (2000). Current status of some zoonoses in Togo. Acta Trop, 76(1):65-9.
4. Roth F, Zinsstag J, Orkhon D et al (2003). Human health benefits from livestock vaccination for brucellosis: case study. Bull World health Organ, 81(12):867-76.
5. Al-Tawfiq JA (2008). Therapeutic options for human brucellosis. Expert Rev Anti Infect Ther, 6(1):109-20.
6. Boluki Z, Bahonar A, Amiri K et al (2017). Estimation of Economic Direct Losses due to Livestock Brucellosis in Iran (2003-2014). Iran J Epidemiol, 12(4):12-21.
7. Esmaeili H (2014). Brucellosis in Islamic republic of Iran. J Med Bacteriol, 3(3-4):47-57.
8. Eini P, Keramat F, Hasanzadehhoseinabadi M (2012). Epidemiologic, clinical and laboratory findings of patients with brucellosis in Hamadan, west of Iran. J Res Health Sci, 12(2):105-8.
9. Sofian M, Aghakhani A, Velayati AA et al (2008). Risk factors for human brucellosis in Iran: a case–control study. Int J Infect Dis, 12(2):157-61.
10. National Guideline for Brucellosis Control (2012). Ministry of Health and Medical Education Health Deputy Center of Communicable Diseases Control Zoonoses Office.
11. Esmaeili H, Esmaeili H, Amiri K (2013). The effects of brucellosis vaccination in domestic animal on human brucellosis in Iran. Razi J Med Sci, 20(109):80-6.
12. GBD 2017 Mortality Collaborators (2018). Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study. Lancet, 392(10159):1684-1735.
13. Murray CJ (1994). Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ, 72(3):429-45.
14. Naghavi M, Abolhassani F, Pourmalek F et al (2009). The burden of disease and injury in Iran 2003. Popul Health Metr, 7:9.
15. Iran Statistical Yearbook (2016). Statistical Center of Iran. https://www.amar.org.ir/english/Iran-Statistical-Yearbook
16. Hasanjani Roush M, Ebrahimpour S (2015). Human brucellosis: An overview. Caspian J Intern Med, 6 (1): 46-47.
17. World Organisation for Animal Health. Handistatus II: zoonoses (human cases): global cases of brucellosis in 2004. http://web.oie.int/hs2/gi_zoon.asp?c_pays=117
18. Gur A, Geyik MF, Dikici B et al (2003). Complications of brucellosis in different age groups: a study of 283 cases in southeastern Anatolia of Turkey. Yonsei Med J, 44(1):33-44.
19. Lulu A, Araj G, Khateeb M et al (1988). Human brucellosis in Kuwait: a prospective study of 400 cases. Q J Med, 66(249):39-54.
20. Mantur BG, Biradar MS, Bidri RC et al (2006). Protean clinical manifestations and diagnostic challenges of human brucellosis in adults: 16 years' experience in an endemic area. J Med Microbiol, 55(Pt 7):897-903.
21. Buzgan T, Karahocagil MK, Irmak H et al (2010). Clinical manifestations and complications in 1028 cases of brucellosis: a retrospective evaluation and review of the literature. Int J Infect Dis, 14(6):e469-78.
22. Geyik MF, Gur A, Nas K et al (2002). Musculoskeletal involvement of brucellosis in different age groups: a study of 195 cases. Swiss Med Wkly, 132(7-8):98-105.
23. Celen MK, Ulug M, Ayaz C et al (2010). Brucellar epididymo-orchitis in southeastern part of Turkey: an 8 year experience. Braz J Infect Dis, 14(1):109-15.
IssueVol 48 No Supple 1 (2019) QRcode
SectionOriginal Article(s)
Incidence Mortality Disability-adjusted life years Brucellosis Iran

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
PIROOZI B, MORADI G, SAFARI H, MOHAMADI P, ALINIA C, SHIRZADI MR, NABAVI M, VAHEDI S, GOUYA MM. Incidence, Mortality, and Burden of Human Brucellosis and Its Geographical Distribution in Iran during 2009-2015. Iran J Public Health. 2019;48(Supple 1):20-27.