Retrospective study of human Brucellosis trends Between 2014-2023 and consideration of One Health perspectives of healthcare professionals in Isiolo County, Kenya

Abstract

Brucellosis, a zoonotic disease, remains a significant public health concern in Kenya. It also has a substantial socio-economic impact, particularly in pastoralist communities such as Isiolo County, here human-animal interactions are common. This study aims to estimate the trends of human brucellosis in Isiolo County over the past decade (2014–2023) through retrospective hospital data, focusing on spatial and temporal patterns and proportional morbidity as well as key informant’s interviews (KII) evaluating barriers to diagnosis, control and effectiveness of current interventions of brucellosis across three study sites (Isiolo, Garbatulla and Merti hospitals). Retrospective data from the 3 hospitals were analyzed, including 10,302 individual test results across the study period, categorized by gender, age, and test outcomes. The retrospective analysis revealed gender disparities, with females representing 65% of tested patients and 61% of positive cases, likely reflecting higher healthcare-seeking behavior among women. Brucellosis was prevalent across all age groups, with individuals aged 19–35 years showing the highest positivity, likely due to occupational exposure to livestock. Variations in hospital-specific prevalence were noted, with Merti hospital consistently reporting higher positivity rates (19%) compared to Garbatulla (16%) and Isiolo (19.7%), which may be linked to higher testing volumes and improved public awareness campaigns. Yearly trends showed fluctuations, with peaks during the COVID-19 pandemic and research-driven testing efforts (2021). KIIs identified knowledge gaps regarding transmission, prevention, diagnostic challenges, including reagent shortages and reliance on less sensitive tests and cultural beliefs and myths hindering timely care-seeking. The study highlights the need for targeted interventions, including increased disease surveillance, public awareness, and improved diagnostic capacity. It emphasizes the significance of site- specific strategies and a One Health approach in addressing zoonotic diseases especially in resource-constrained settings. Further research is needed to assess the effectiveness of current control measures and address data gaps.