Brucellosis in the One Health Context: Gaps in Diagnosis, Control, and Global Epidemiology.

Abstract

Background: Brucellosis is a neglected zoonotic infection with persistent transmission in many endemic regions despite long-standing control efforts. Limitations in diagnosis, fragmented surveillance systems, and inconsistent implementation of control measures continue to hinder effective disease management. The objective is to critically examine current gaps in the diagnosis, global and regional epidemiology, and control of brucellosis within a One Health framework.

Methods: A structured narrative review was conducted using PubMed, Scopus, and Web of Science. Peer-reviewed articles, reviews, and relevant reports published in English were screened using predefined keywords related to brucellosis, diagnosis, epidemiology, treatment, and control. Studies were selected based on relevance to human and animal disease, diagnostic approaches, and public health implications. Data were synthesized qualitatively with emphasis on diagnostic limitations, surveillance gaps, and intersectoral challenges.

Results: Evidence indicates that brucellosis remains underdiagnosed and underreported globally, particularly in low- and middle-income countries. Serological assays, although widely used, are limited by cross-reactivity and variable performance, while culture and molecular methods face constraints related to biosafety, cost, and accessibility. Marked regional heterogeneity reflects differences in veterinary infrastructure, food safety practices, and surveillance capacity. Inadequate integration between human and animal health sectors continues to undermine control efforts.

Conclusions: Persistent gaps in diagnostics, surveillance, and coordinated control strategies contribute to ongoing transmission of brucellosis. Strengthening One Health approaches, improving access to standardized diagnostic tools, and enhancing surveillance systems are essential for reducing the global burden of disease.