Brucellosis as a One Health Challenge: Diagnosis, Control and Future Directions

Brucellosis as a One Health Challenge: Diagnosis, Control and Future Directions Usama Ghaffar1, Muzafar Ghafoor1, Eman Noor2, Amna Iftikhar3 , Rai Bahadur Kharl1, Muhammad Adan Sana4, Anees-ur-Rehman1, Rabia1 1Department of Clinical Medicine and Surgery, University of Agriculture, Faisalabad, Pakistan. 2Institute of Biochemistry and Biotechnology, UVAS, Lahore, Pakistan. 3University Medical & Dental College, Faisalabad, Pakistan. 4Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan. *Corresponding authors: drusamaghaffar@gmail.com Abstract Brucellosis, caused by bacteria of the genus Brucella, is an important zoonotic disease of global significance of great public health and economic importance. The disease affect mainly the livestock causing reproductive failure and decreased productivity while human infection is associated with wide variety of clinical manifestations ranging from acute febrile illness to chronic complications including osteoarticular disease, neurobrucellosis, and endocarditis. Despite the availability of conventional diagnostic tools and vaccines, brucellosis is still endemic in many regions especially in low- and middle-income countries, which is attributed to limitations related to surveillance, diagnostics and control programs. The current state of knowledge for the epidemiology, clinical features, diagnostic difficulties, and control strategies of brucellosis are summarized in this review. Emphasis is made on the relevance of One Health approach where human, animal and environmental health sectors are integrated for effective management of these diseases. Advances in molecular diagnostic techniques such as polymerase chain reaction-based techniques and new biosensor technology are highlighted as some of the promising tools for early detection. In addition, the numerous issues of antimicrobial resistance were highlighted, taking into consideration the importance of proper antimicrobial stewardship and development of safer and more efficacious vaccines. Strengthening collaboration, research, and policy frameworks across the globe through coordinated One Health approach is essential in tackling burden of brucellosis on public health, agriculture systems throughout the world. Keywords: Brucellosis; One Health; Zoonotic diseases; Molecular diagnostics; Antimicrobial resistance