GAP ANALYSIS: SMALL RUMINANTS BRUCELLOSIS CONTROL AND ERADICATION PROGRAM IN BOSNIA AND HERZEGOVINA Open Access

Abstract

Brucellosis is a global zoonosis caused by the Brucella bacteria. It is a very contagious disease, accompanied by great economic loss, of various ruminant animals that can be transmitted to humans and cause debilitating illness. The disease is well controlled in developed countries due to implementation of sustainable vaccination and surveillance programs. Nevertheless, brucellosis is endemic in many developing countries around the world, especially in the Mediterranean region with recent epidemic outbreaks of Brucella melitensis infection in sheep and goats, and subsequently in humans, in Bosnia and Herzegovina.

The purpose of this project was to analyze and evaluate the recent changes in the brucellosis prevention program in sheep and goats in Bosnia and Herzegovina with the aim to discover and address any gaps in the new program, as well as to make specific recommendations for program improvement based on the Socio-Ecological framework for prevention. After an extensive literature review and numerous expert key informant interviews, it can be concluded that the newly implemented small ruminants vaccination program is very successful and has accomplished its initial aim to control brucellosis outbreaks in Bosnia and Herzegovina. Despite its overall success, there are many gaps that exist in the new program and country specific recommendations can be made to further strengthen the program and improve the chance of a long-term brucellosis control and eradication in the entire Bosnia and Herzegovina. Specific recommendations target the five essential benchmarks for the overall program success and include the following: 1) Animal Registration, Identification, and Movement Control, 2) Strategic Brucellosis Vaccination Process, 3) Accurate and Timely Brucellosis Testing/Routine Surveillance, 4) Quality Assurance/Quality Control Program, and 5) Continuous and Targeted Brucellosis Education.

Table of Contents

TABLE OF CONTENTS

CHAPTER I: INTRODUCTION ___________________________________________ 1
Rationale ______________________________________________________________ 1
Problem Statement ______________________________________________________ 3
Significance Statement ___________________________________________________ 4
Definition of Terms______________________________________________________ 6

CHAPTER II: REVIEW OF THE LITERATURE _____________________________ 8
Introduction ____________________________________________________________ 8
Bosnia and Herzegovina __________________________________________________ 8
Etiology ______________________________________________________________ 10
Epidemiology __________________________________________________________11
Diagnosis_____________________________________________________________ 12
Surveillance___________________________________________________________ 14
Brucella Vaccine _______________________________________________________ 16
US Success in Brucellosis Control and Eradication ____________________________ 17
Brucellosis Status in Europe ______________________________________________ 18
Support System within European Union and beyond ___________________________ 21
Legislative Requirements _________________________________________________23
Progress in Bosnia and Herzegovina _______________________________________ 24
Summary of Current Problem and Study Relevance ___________________________ 28

CHAPTER III: METHODOLOGY ________________________________________ 29
Introduction ___________________________________________________________ 29
Research Design _______________________________________________________ 29
Limitations ___________________________________________________________ 31
Emory University Institutional Review Board Clearance _______________________ 32

CHAPTER IV: RESULTS _______________________________________________ 33
Introduction ___________________________________________________________ 33
Benchmark#1: Animal Registration, Identification, and Movement Control _________ 34
Benchmark#2: Strategic Brucellosis Vaccination Process _______________________ 37
Benchmark#3: Accurate and Timely Brucellosis Surveillance ___________________ 43
Benchmark#4: Quality Assurance and Quality Control Program __________________ 46
Benchmark#5: Continuous and Targeted Brucellosis Education __________________ 49

CHAPTER V:CONCLUSIONS, IMPLICATIONS, AND RECOMMENDATIONS __ 52
Introduction ___________________________________________________________ 52
Conclusions and Recommendations ________________________________________ 52
Public Health Implications _______________________________________________ 56

REFERENCES ________________________________________________________ 57

About this Master's Thesis

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School	Rollins School of Public Health
Department	Career Masters of Public Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	gap analysis zoonosis vaccine small ruminants public health Brucellosis
Committee Chair / Thesis Advisor	Butler, Susan O, Emory University
Committee Members	Baldwin, Grant T., Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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