Background: Brucellosis, a major zoonotic disease, is highly present in Iran, especially in Lorestan province. The aim of this study was to understand the issues related to Brucellosis utilizing the multiple streams framework.
Methods: A two-step method was adopted: i) assessment of brucellosis-related documents and ii) interviews with stakeholders.
Results: The problem stream was characterized by: 1) high prevalence of the disease, 2) traditional livestock production, 3) unsafe animal slaughtering, 4) centers for the sale and distribution of non-authorized dairy products, 5) raw milk and 6) traditional unsafe dairy products consumption, 7) incomplete livestock vaccination, 8) lack of knowledge of Brucellosis, 9) neighboring countries with high prevalence of Brucellosis, 10) lack of livestock quarantine, and 10) nomadic immigration. The policy stream was characterized by 1) primary healthcare networks, 2) guidelines, 3) medicines, insurance, and 4) diagnostic services. Finally, the political stream was characterized by: 1) support of the University of Medical Sciences, 2) sponsorship by the Ministry of Health and Medical Education, 3) Health transformation plan, and 4) Working Group on Health and Food Security in Lorestan.
Conclusion: This study examined the brucellosis-related agenda setting: if different issues are taken into consideration, it can be perceived as a health priority.
2. Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005;352(22):2325-36.
3. Madzingira O, Sezuni PM. Serological prevalence and public health significance of Brucellosis on a dairy farm in Namibia from 2011 to 2014. BMC Res Notes. 2017;10(1):620.
4. Singh BB, Khatkar MS, Aulakh RS, Gill JPS, Dhand NK. Estimation of the health and economic burden of human Brucellosis in India. Prev Vet Med. 2018;154:148-55.
5. McDermott J, Grace D, Zinsstag J. Economics of brucellosis impact and control in low-income countries. Rev Sci Tech. 2013;32(1):249-61.
6. Singh BB, Kostoulas P, Gill JPS, Dhand NK. Cost-benefit analysis of intervention policies for prevention and control of Brucellosis in India. PLoS Negl Trop Dis. 2018;12(5):e0006488.
7. Shome R, Kalleshamurthy T, Shankaranarayana PB, Giribattanvar P, Chandrashekar N, Mohandoss N, et al. Prevalence and risk factors of Brucellosis among veterinary health care professionals. Pathog Glob Health. 2017;111(5):234–9.
8. Hanot Mambres D, Boarbi S, Michel P, Bouker N, Escobar-Calle L, Desqueper D, et al. Imported human Brucellosis in Belgium: Bio and molecular typing of bacterial isolates, 1996-2015. PLoS One. 2017;12(4):e0174756.
9. Shafee M, Rabbani M, Sheikh AA, Ahmad MD, Razzaq A. Prevalence of bovine brucellosis in organized dairy farms, using milk ELISA, in quetta city, balochistan, pakistan. Vet Med Int. 2011;2011:358950.
10. Roth F, Zinsstag J, Orkhon D, Chimed-Ochir G, Hutton G, Cosivi O, et al. Human health benefits from livestock vaccination for Brucellosis: case study. Bull World Health Organ. 2003;81(12):867-76.
11. Alavi SM, Alavi L. Treatment of Brucellosis: a systematic review of studies in recent twenty years. Caspian J Intern Med. 2013;4(2):636–41.
12. Dean AS, Crump L, Greter H, Schelling E, Zinsstag J. Global burden of human brucellosis: a systematic review of disease frequency. PLoS Negl Trop Dis. 2016;6(10):e1865.
13. Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis. 2006;6(2):91-9.
14. Karimi A, Karimi B. Epidemiological Status of Brucellosis in Abadeh County, Fars Province, Iran in 2011-2017. J Community Health Res. 2018;7(3):183-91.
15. Piroozi B, Moradi G, Safari H, Mohamadi P, Alinia C, Shirzadi MR, et al. Incidence, mortality, and burden of human Brucellosis and its geographical distribution in Iran during 2009-2015. Iran J Public Health. 2019;48(Supple 1):20-7.
16. Kingdon JW. Agendas, alternatives, and public policies. 2, editor. New York: Longman; 2011.
17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus group. Int J Qual Health Care. 2007;19(6):349-57.
18. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12.
19. Colombini M, Mayhew SH, Hawkins B, Bista M, Joshi SK, Schei B, et al. Agenda setting and framing of gender-based violence in Nepal: how it became a health issue. Health Policy Plan. 2016;31(4):493-503.
20. Khan HA, Akram W, Shad SA, Razaq M, Naeem-Ullah U, Zia K. A cross sectional survey of knowledge, attitude and practices related to house flies among dairy farmers in Punjab, Pakistan. J Ethnobiol Ethnomed. 2013;9:18.
21. Zhang N, Zhou H, Huang DS, Guan P. Brucellosis awareness and knowledge in communities worldwide: a systematic review and meta-analysis of 79 observational studies. PLoS Negl Trop Dis. 2019;13(5):e0007366.
22. Liaropoulos L, Goranitis I. Health care financing and the sustainability of health systems. Int J Equity Health. 2015;14:80.
23. Iwelunmor J, Blackstone S, Veira D, Nwaozuru U, Airhihenbuwa C, Munodawafa D, et al. Toward the sustainability of health interventions implemented in sub-Saharan Africa: a systematic review and conceptual framework. Implement Sci. 2016;11:43.
24. Caiola C, Docherty SL, Relf M, Barroso J. Using an intersectional approach to study the impact of social determinants of health for African American mothers living with HIV. ANS Adv Nurs Sci. 2014;37(4):287-98.
25. Caniza MA, Maron G, McCullers J, Clara WA, Cedillos R, Dueñas L, et al. Planning and implementation of an infection control training program for healthcare providers in Latin America. Infect Control Hosp Epidemiol. 2007;28(12):1328-33.
26. Behzadifar M, Gorji HA, Rezapour A, Behzadifar M, Bragazzi NL. The role of insurance providers in supporting treatment and management of hepatitis C patients. BMC Health Serv Res. 2019;19(1):25.