Epidemiological and public health aspects of brucellosis in the Republic of Macedonia.

AIM To analyze and present epidemiological patterns of human brucellosis cases and the main factors for the appearance and spread of B. melitensis infection among animals and humans in R. Macedonia in the period from 1980 to 2009. METHODS Retrospective study based on the epidemiological reports and official data on brucellosis cases from the Institute for Public Health in Skopje and other institutions from the health and veterinary sectors in R. Macedonia, and a review of the relevant literature. RESULTS From 1980 until December 2009, a total of 11,451 brucellosis cases were reported in R. Macedonia, with a mean annual incidence rate of 18.9/100,000. The highest morbidity rate during this period was recorded in 1992 (922 cases and an incidence rate of 47.6/100,000), and the lowest one in 1983 (12 cases and an incidence rate of 0.6/100,000). From the total number of cases reported in R. Macedonia from 1980 to 2009, 66.2% were males and 33.8% were females. Only 7.2% of patients were under the age of 10, and the most of the patients were from the age group 20-39 (31.9%). Seasonal characteristics of the disease were expressed with the highest occurrence in May (15.9%), June (16.3%) and July (15.1%). Within the total number of 3,284 brucellosis cases in the period 2001-2009, 2320 (70.6%) were from rural settlements and 964 (29.4%) from urban areas. 385 of all cases of brucellosis (8.4%) reported in the period 1998-2009 were from the ranks of professional staff. CONCLUSION Brucellosis was, currently is and will be a significant disease problem and concern in R. Macedonia which should be approached in a more comprehensive and organized way in the coming years. There is a need to establish intersectoral collaboration by joint efforts of all relevant factors in the prevention and eradication of brucellosis, as well as collaboration between all countries in the SEE region.