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Background <p>Brucellosis is a neglected and re-emerging zoonotic disease of nearly worldwide distribution. Recently, a new model utilizing publicly available data, voluntarily provided by countries to the World Organization for Animal Health (WOAH), estimated a global annual incidence of at least 1.62–2.10&#xa0;million cases. However, global and regional knowledge gaps, partially attributed to lack of diagnostic capability and disease unawareness, result in misdiagnosis.</p> Methods <p>This study incorporated misdiagnosis to assess the potential impact on incidence estimates. Specifically, we examined the potential impact of misdiagnosing brucellosis as malaria. Incidence rates modeled from WOAH data comprised a baseline estimate for brucellosis rates. A range of potential misdiagnosis rates based on World Bank malaria data and scientific literature were utilized to estimate the number of misdiagnosed cases. We assumed a conservative misdiagnosis range of 0.25-4.00% based on clinical studies that reported a 4–11% misdiagnosis rate.</p> Results <p>We show that malaria misdiagnosis can significantly impact global annual incidence estimation of brucellosis. Rates of 0.25% increase brucellosis incidence by 0.34-5.4&#xa0;M cases, while rates of 4% increase these estimates by 2.43-7.45&#xa0;M cases.</p> Conclusions <p>Human brucellosis misdiagnosed as malaria can significantly impact global annual incidence estimates. Enhanced efforts are needed to identify misdiagnosed cases in countries where both diseases are endemic.</p>

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Malaria misdiagnosis substantially contributes to the underestimation of global human brucellosis incidence

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月16日

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  • Christopher G. Laine,
  • Valen E. Johnson,
  • H. Morgan Scott,
  • Angela M. Arenas-Gamboa

摘要

Background

Brucellosis is a neglected and re-emerging zoonotic disease of nearly worldwide distribution. Recently, a new model utilizing publicly available data, voluntarily provided by countries to the World Organization for Animal Health (WOAH), estimated a global annual incidence of at least 1.62–2.10 million cases. However, global and regional knowledge gaps, partially attributed to lack of diagnostic capability and disease unawareness, result in misdiagnosis.

Methods

This study incorporated misdiagnosis to assess the potential impact on incidence estimates. Specifically, we examined the potential impact of misdiagnosing brucellosis as malaria. Incidence rates modeled from WOAH data comprised a baseline estimate for brucellosis rates. A range of potential misdiagnosis rates based on World Bank malaria data and scientific literature were utilized to estimate the number of misdiagnosed cases. We assumed a conservative misdiagnosis range of 0.25-4.00% based on clinical studies that reported a 4–11% misdiagnosis rate.

Results

We show that malaria misdiagnosis can significantly impact global annual incidence estimation of brucellosis. Rates of 0.25% increase brucellosis incidence by 0.34-5.4 M cases, while rates of 4% increase these estimates by 2.43-7.45 M cases.

Conclusions

Human brucellosis misdiagnosed as malaria can significantly impact global annual incidence estimates. Enhanced efforts are needed to identify misdiagnosed cases in countries where both diseases are endemic.