Peculiarities of Brucellosis Spread in Urban and Rural Areas of Jalal-Abad Region, Kyrgyz Republic

INTRODUCTION

Brucellosis is also among the most endemic zoonotic diseases that share the same geographical area where livestock rearing is still a key component of the economy and livelihood. The disease remains a challenge to the public health and veterinary field despite the established control programs of the disease, since it has complex transmission and affects both animals and humans. The health condition of citizens living in the places of brucellosis infestation is greatly determined by the efficiency of the prevention, timely observation of cases, proper treatment, and isolation of infected animals and carriers (Qureshi et al., 2023). The sanitary and veterinary activities of monitoring livestock, safe animal husbandry, and control of slaughtering activities and sale of meat and dairy products should be coordinated in order to reduce the incidence of zoonotic diseases. The clinical importance of human brucellosis is due to its ability to develop systemic complications. The infection can cause inflammatory and degenerative lesions of the different organs and systems, such as epididymitis, orchitis, prostatitis, cervicitis, salpingitis, sacroiliitis, radiculitis, plexitis, bursitis, corneal ulcers, and endocarditis (Shin et al., 2024). These manifestations lead to long-term morbidity, temporary or permanent disability, as well as poor quality of life. The preventative approach thus goes deeper into the area of medical therapy and incorporates the part of enhancing veterinary control, advancing animal husbandry safety, and educating the public on food safety and work-related safety. The fact that the collaboration between the public health and veterinary services is one of the essential requirements to ensure the effective control of brucellosis and to reduce the epidemiological and economic impact (Hoy-Gerlach & Townsend, 2023).

Although preventive and anti-epidemic measures have been taken, brucellosis is still reported in numerous areas every year, which means that the animal population becomes infected and poses a significant threat to the human population. The differences in living standards, work exposure, and access to veterinary care have a tendency to result in dissimilarity between urban and rural cohorts (Ntivuguruzwa et al., 2025). The rural dwellers, especially those who deal with livestock breeding and processing of animal products, might be exposed to more risks of being affected by infected animals or deteriorating raw products (Moreno et al., 2022). Simultaneously, the urban cases can also be related to the use of raw dairy products or, eventually, illegal meat trading. These contextual conditions build a heterogeneous epidemiological environment that needs to be assessed, which is region-specific. The issue is further added by the chronic nature of the disease as well as the challenges linked to early diagnosis (Almuzaini & Elbehiry, 2025). Non-specific clinical manifestations at the early stages may postpone medical attention and lab verification, and help in creating underreporting or delayed therapy. Besides this, lack of adherence to sanitation in animal farming, lapses in the ratio of vaccination in livestock, and the unofficial business of animal food products could perpetuate infection cycles. Follow-up of demographic factors such as age, gender, and working status, as well as the location of residence, is thus crucial in the detection of the vulnerable populations and enhancement of the specific means of prevention. Without the systematic epidemiological research on the levels of the region, the performance of the implemented measures can hardly be estimated, as well as the areas that need stronger control (George et al., 2021).

These challenges are considered by the current study by carrying out an elaborate epidemiological examination of the incidence of brucellosis in the urban and rural populations of the Jalal-Abad region during a specific observation period. The innovation of the presented work is the presence of a full evaluation of the dynamics of long-term incidence with the stratification of the populations by residence and groups. The study does not investigate overall morbidity only, but incorporates urban and rural differences, risky social groups, and patterns that should be implemented to assist in the planning of the health of populations. The other research's unique characteristic is the combination of epidemiological results and the contextual risk factors based on the livestock exposure and population structure. The investigation will offer a better insight into the distribution of brucellosis in the area over time and across populations of incidence. In this way, a more accurate definition of risk groups can be achieved, and evidence-based preventive actions can be developed in accordance with local factors. The objective of the work is to carry out the epidemiology of the incidence of brucellosis in the population in the city and rural areas of the region of Jalal-Abad. The study aims to offer a factual foundation for enhancing prevention, reinforcing control efforts, and alleviating the brucellosis burden in the area through the systematic analysis of the morbidity indicators and population features.

MATERIALS AND METHODS

Study design and setting

This study was designed as a retrospective descriptive epidemiological analysis of officially registered cases of brucellosis in the Jalal-Abad region. The analysis covered a ten-year observation period (2014–2024) and included both urban and rural populations of the region. The objective was to assess incidence dynamics, identify demographic and territorial differences, and determine the distribution of cases across population groups.

Data sources

The study was based on official surveillance data obtained from district and city Centers for Disease Prevention and Sanitary and Epidemiological Surveillance (CDSES). The primary source of information was the monthly and annual statistical reporting Form No. 1, “On Infectious and Parasitic Diseases.” These reports are routinely compiled at the district and city levels and subsequently submitted to the Regional CDSES, where consolidated data are maintained. The dataset included information on the number of registered brucellosis cases, population size, place of residence (urban or rural), age categories, gender distribution, and social or occupational status of patients. Data on sources of infection and laboratory-confirmed pathogen characteristics were also considered when available in official records. Only officially registered and confirmed cases recorded in the reporting system were included in the analysis.

Inclusion criteria

All confirmed cases of brucellosis registered in the Jalal-Abad region during the study period were included. Cases were classified according to standard reporting categories used in the national surveillance system. Population data used for calculating incidence rates were based on official regional demographic statistics corresponding to each reporting year.

Epidemiological indicators

The main epidemiological indicator analyzed was the incidence rate per 100,000 population. Incidence rates were calculated separately for: Total population, urban population, rural population, child population, and gender groups. Comparative analysis was performed to assess differences between urban and rural areas, as well as between male and female populations. The distribution of cases across social and occupational groups was analyzed in percentage terms.

Statistical analysis

Analytical and statistical processing of the data was carried out using a personal computer. Calculations were performed in Microsoft Excel 2002 utilizing the “Analysis ToolPak” package within the Windows XP operating environment. Dynamic analysis was conducted to evaluate trends in incidence over the ten-year study period. Results are presented in tabular and calculated form, with emphasis on identifying epidemiologically significant differences between territorial and demographic groups.

Ethical considerations

The study protocol was reviewed and approved by the Ethical Committee of Osh State University, Osh City, Kyrgyzstan. All procedures were conducted in accordance with the principles outlined in the Declaration of Helsinki (World Medical Association, 2013). No personal identifiers were used, and confidentiality of patient information was fully maintained throughout the study.

RESULTS AND DISCUSSION

Impact of the COVID-19 pandemic on brucellosis detection in 2020 

The regional statistics committee has the latest data that reveals that the total population in Jalal-Abad Oblast is 1,306,704 individuals. Among them, 430,770 are children aged 14 and lower which is a significant percentage of the population. This population setup can be used to explain the rates of incidence, especially when one carries out an analysis by age. The evaluation of brucellosis incidence in most of the ten years (2014-2024) shows a general decreasing trend. The rate of incidence in 2014 was 36.9 cases in 100,000 citizens. This information demonstrated that by 2024, the number had dropped to 23.8 cases per 100,000 people. The decrease will be a slight decrease in registered cases over the course of the study that would reflect an improvement in the epidemiological situation (Figure 1).

The most marked shift in the general trend was also seen in 2020 when the incidence rate decreased to 18.7 cases per 100,000 population. This reduction was in relation to the COVID-19 pandemic. At this stage, the development of a few healthcare uses and access to medical services possibly affected the identification and reporting of new cases of brucellosis. Consequently, the decreased figure in 2020 is to be taken cautiously since, in part, it can be attributed to a decrease in the identification of cases and less so to the decrease in transmission. All in all, the long-term statistics demonstrate a slight decrease in the rate of brucellosis in the area. Nonetheless, other external conditions, such as the COVID-19 pandemic disruptions, are to be viewed when examining short-term fluctuations in reported rates.

Gender differences in brucellosis incidence and temporal trends (2014–2024)

The incidence of brucellosis in the area from 2014 to 2024 is statistically analyzed, which proves the existence of gender disparities in the prevalence of this disease. Figure 2. The prevalence of brucellosis is such that there are more males than females. The median prevalence rate in males stood at 63.1, but the range of values was 56.5 to 68.7. In women, the rate was considerably lower, being 36.9, and ranged between 31.3 and 43.5. The incidence is very dynamic over time. The latest data indicate that the highest prevalence rates among the male population were registered in 2024 (68.7%), whereas the lowest level of the indicator was observed in 2016 (56.5%). The same could not be said of women: the highest incidence rate was reached in 2016 (43.5%), and the lowest in 2024 (31.3%). The results obtained show some seasonality and periodicity in the distribution of brucellosis among various groups of genders in the area.

Though the proportion of women and men in urban and rural areas is equal, with 50% of the rural population consisting of women and 50% of the men (Table 1), there are noticeable disparities in the rural morbidity of brucellosis. Men constituted 70.8 per cent of all registered cases among the rural residents, and women constituted 29.2 per cent. The incidence ratio has been calculated, and it shows that the women residing in rural districts have about 2.4 times less chance of developing brucellosis compared to men. Such a discrepancy could be linked to variations in work, contact with livestock, and the type of farming work, specifically between men, which carries more direct animal contact and manipulation of animal products. These results indicate that there is a very large gender based gap in the risk of brucellosis infection in rural regions, although among the entire population of men and women, the proportions have been equal (Alhussain et al., 2022; Balaji et al., 2022; Constantin et al., 2022; Mojsak et al., 2022; Sugimori et al., 2022; Delcea et al., 2024; Essah et al., 2024; Frost et al., 2024; Kajanova & Badrov, 2024; Lee & Ferreira, 2024; Ribeiro et al., 2024; Rosellini et al., 2024; Sanlier & Yasan, 2024; Umarova et al., 2024; Uneno et al., 2024).

Table 1. Brucellosis incidence in urban and district population by gender in the Jalal-Abad region of the Kyrgyz Republic for 2024

Age, territorial, and clinical characteristics of brucellosis incidence

The epidemiological situation analysis showed the presence of significant differences between the prevalence of brucellosis in various population groups. The incidence was also higher among children below 14 years of age, as it recorded 33.9 cases per 100,000 children as opposed to 23.8 cases per 100,000 adults. There were also evident inequalities between rural and urban regions according to geographic distribution. The rate of infection was nearly twice in rural areas (26.4 cases per 100,000 population) compared to the urban areas (15.6 cases per 100,000 population). It was especially noticeable in children, where the incidence rate was much higher in rural areas (16.1 cases per 100,000 children), which is 3.8 times higher than the incidence in urban areas (4.2 cases per 100,000) (Table 2).

There was also a difference in the place of residence in the clinical structure of the disease. In total, the acute type of Brucellosis was the most common in the area, which claimed 92 percent of the total number. Acute form was detected in 96.1 percent of rural regions, and only 3.9 percent of these cases developed into chronic forms. However, in urban areas, the situation was different: 58.8% of cases were acute, whereas in rural areas, the cases were 41. 2% chronic. Such results show a clear pattern of territory when it comes to incidence as well as disease progression. The census of rural children and the higher proportion of chronic cases in urban populations indicate that urban and rural areas should be presupposed by the differentiated prevention and treatment measures, paying attention to the epidemiological peculiarities of every region.

Table 2. Brucellosis incidence in rural and urban populations Jalal-Abad region of the Kyrgyz Republic for 2024 by type of disease (intensive indicator per 100 thousand population)

Age and territorial patterns of brucellosis incidence in the population

The prevalence of Brucellosis spreads in the area across all ages. In Table 3, the epidemiological profile shows that there is clear age dispersion with different incidences (Adeleke, 2022; Sri et al., 2022; Guzek et al., 2023; Simonyan et al., 2023; Tsiganock et al., 2023). The greatest level of incidence is observed in the population older than 30 years of age, which is 27.2 cases per 100 thousand population. The second position is filled by adolescents within the age bracket 15-19 years, with an indicator of 24.3 cases. Children between the ages of 6 and 14 years (18.9 cases) form the third place. The 20-29 age group shows the lowest level of incidence in this group (14.5 cases). It has a higher incidence among those in the rural population than it does in the urban population. Of particular difference is the child population: Rural: - children aged 0-5 years old: 4.7 cases per 100 thousand. Children 6-14 years old: 21.6 cases per 100,000. In the cities, no cases were reported under 0-5 years. Children aged 6-14 years old: 6.8 cases/100 000 (3.2 times less than those in rural areas). It is also interesting to note that the incidence rates are nearly the same in the elderly age group (above 30 years) in rural (27.3 cases) and urban (26.4 cases) regions. Nevertheless, there is a remarkable disparity between the youths: the percentage of 15-19-year-olds in the country is 1.5 times higher. Among the 20-29 age bracket, the same trend whereby the rural indicators appear more than 1.5 times higher. The received information demonstrates that socio-economic factors and lifestyle play a major role in the occurrence of brucellosis among various age and territorial groups of the residents (Razhaeva et al., 2022; Rojas et al., 2022; Al Abadie et al., 2023; Lee et al., 2023; Aksoy & Akaydin, 2025; Kebe et al., 2025).

Table 3. Brucellosis incidence in urban and rural population by age structure in the Jalal-Abad region for 2024

Socio-demographic distribution of brucellosis cases

The largest percentage of brucellosis was registered in the unemployed population, taking 44.1% of the cases, taking the leading role in all the social groups (Table 4). None of these are rural since most of them are urban dwellers in suburban settlements or household whichever of them tend to keep small-scale livestock farming. They normally maintain an animal population of between 2 and 4 and 10-15 head of small livestock and 1-3 head of cattle with full-time animal care. In the rural districts, 38.8% of the cases of brucellosis were seen among the unemployed population, with the total burden of the area being 39.4, indicating a strong burden at all times.

School children came second in incidence structure, where they had a regional average of 19.3. The incidence among the schoolchildren was 8.8 in urban areas and 20.6 in rural areas. The elevated rates, especially in rural areas, are linked with the indirect exposure of children to the exposure by the weathering of parents in the care of livestock and household farming activities. The working population was in the third rank and had a regional average incidence as 14%. In urban localities, this incidence was 23.5 and 12.8 in the rural localities. Much to the point, however, it was 1.8 times higher in urban workers as compared to rural workers, which can be explained by some urban residents (who do live in the outskirts) also being occupied with livestock rearing. Another category consists of pensioners: significantly higher territorial disparity was also noted here, 5.8% urban and 10.7% rural. The relatively increased cases in the two settings are probably attributable to the active engagement in retirement in the form of private farming and livestock rearing.

Table 4. Brucellosis incidence in the rural population by cohort. Jalal-Abad region of the Kyrgyz Republic for 2024.

Epidemiological structure of brucellosis infection sources

The research formed the following structure of the sources of brucellosis infection in the area (Table 5). Small ruminants were identified as the ones with the most epidemiological importance. In the rural regions, there were 51.9 cases per 100000, which were related to small ruminant infections, and in urban regions, the ratio was significantly smaller at 23.5. The average weighted in this region was 48.9, which proved its dominance in transmission. Cattle were in the second place in the category of sources of infection. Forty-one point two percent of cases were associated with cattle in the rural environment, relative to 17.4 percent in the urban environment. At the regional level, 20 of the infections were related to cattle. A significant part of the cases were the unknown sources of infection. In cities, the source was not identified in 35.3% of cases, and in villages, this was 30.7%. Altogether, there were 31.1 percent of cases in the region in which the source had not been recorded. The results indicate the importance of bettering epidemiological surveillance, enhancing the ability to trace the origin of infections, and improving investigation protocols used to make sure that even cases of brucellosis are identified as having more accurate transmission pathways.

Table 5. Sources of brucellosis infection in cities and districts of the Jalal-Abad region of the Kyrgyz Republic for 2024

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