Time and Space Dynamics of Brucellosis in Albania in Relation to Control Interventions

Introduction: Brucellosis remains a common disease in many Mediterranean countries and continues to be a threat to the public health and the agriculture economy. This paper aims to analyse the changes in time and space of the human brucellosis in Albania, with a focus on the last decade and in the context of the prevention measures. Methods: for the human brucellosis analyses, two datasets are used; hospitalizations and epidemiological surveillance. Study period is 2010-2020, but other historical data are also used to feed the analyses. Additional data from veterinary service about clusters of the disease in animals, as well as timeline of vaccination programs, were also collected. Results: This is the first study to document the continuous decrease of brucellosis incidence rates in humans since 2005, and especially since 2011, when nationwide control programs were introduced. From 37.5/100000 in 2004, yearly incidence fell to 3.4/100000 in 2019, with an average decrease of 10%-20% every year. The prevalence of infection in animals followed a similar trend. The decline in incidence over the ten years was highest in Korce (6.5 times) and lowest in Diber (only 50%). The fall of reported cases in the pandemic year 2020 was unexpected, with 4.2 times less cases than those reported in the previous year. Conclusion: The sustained decline in cases of human brucellosis is associated with the mass vaccination of animals. Although under control in 2019, the brucellosis is far from being eradicated in Albania, with cases reported from more than half of municipalities and an apparent stagnation in northeastern regions.