A one health indicator-based policy and implementation gap analysis of brucellosis control in Iran: A scoping review
- 1Razi Vaccine and Serum Research Institute, Agricultural Research, Education and Extension Organization (AREEO), Karaj, Iran
Abstract
Background: Brucellosis remains endemic in Iran despite more than six decades of vaccination, surveillance, and test-and-slaughter activities. However, the national control program has not been systematically assessed against internationally recognized progressive-control frameworks. We conducted a descriptive and exploratory scoping review combined with an indicator-based policy and implementation gap analysis. The study was not designed to test a conventional epidemiological hypothesis or estimate causal effects. Methodology/Principal Findings: We developed 45 measurable indicators by adapting the Food and Agriculture Organization Stepwise Approach for the Progressive Control of Brucellosis across five domains: governance, surveillance, laboratory capacity, prevention and control, and communication. The indicators were informed by nine international normative sources and reviewed by three subject-matter experts. We searched PubMed, Scopus, Web of Science, and Google Scholar for scientific literature published between January 2000 and March 2026 and manually screened relevant publicly accessible official documents, including earlier legal and regulatory sources. Seventy-one eligible documents were included. Two reviewers independently scored all indicators using predefined criteria. Exact agreement was 86.7% (39/45), and weighted Cohen's kappa calculated from the original independent pre-consensus scores was 0.84 (95% CI 0.72–0.93). The six disagreements were resolved by consensus. Overall stage classification was determined separately using a rule-based algorithm based on documented program prerequisites rather than aggregated indicator scores. Under the adapted framework, Iran met the minimum documented prerequisites associated with Stage 3. Major implementation or documentation gaps remained in animal identification and traceability, early warning, laboratory partnerships, wildlife and nomadic-population risk management, joint risk assessment, and public reporting. Six interdependent policy priorities were identified. Conclusions/Significance: Iran has established important foundations for brucellosis control, but several integrated and elimination-oriented functions remain incomplete or undocumented. The Stage 3 classification is a framework-based interpretation of publicly available documentary evidence, not an official designation or an independently validated measure of national program performance. The framework may support systematic gap identification and program monitoring, but prospective and external validation is required before its broader application. Author summary: Brucellosis is an infection transmitted from animals to humans that causes chronic illness, livestock losses, and food-safety risks. Although Iran has implemented vaccination, testing, and public-education programs for more than six decades, the disease remains endemic. We developed 45 measurable indicators to examine the documented strengths and gaps of the national control program across governance, surveillance, laboratory capacity, prevention and control, and communication. We reviewed 71 scientific and publicly accessible official documents and assessed each indicator using predefined criteria. We found that Iran has established important foundations for brucellosis control and meets the minimum documented requirements associated with the third stage of the adapted progressive-control framework. However, several systems required for further progress remain incomplete or undocumented, including animal traceability, early warning, laboratory partnerships, wildlife and nomadic-population risk management, coordination between human and animal health authorities, and public reporting. We identified six interconnected policy priorities to address these gaps. Because our assessment relied on publicly available documents, failure to retrieve evidence does not necessarily mean an activity does not exist. The framework may support transparent planning and monitoring but requires further validation before broader use.
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BibTeX
@article{dadar2026health,
title = {{A one health indicator-based policy and implementation gap analysis of brucellosis control in Iran: A scoping review}},
author = {Maryam Dadar and Zahra Baradaran-Seyed},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = nov,
doi = {10.1371/journal.pntd.0014690},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014690},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A one health indicator-based policy and implementation gap analysis of brucellosis control in Iran: A scoping review
AU - Maryam Dadar
AU - Zahra Baradaran-Seyed
PY - 2026
DA - 2026/11/06
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0014690
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014690
AB - Background: Brucellosis remains endemic in Iran despite more than six decades of vaccination, surveillance, and test-and-slaughter activities. However, the national control program has not been systematically assessed against internationally recognized progressive-control frameworks. We conducted a descriptive and exploratory scoping review combined with an indicator-based policy and implementation gap analysis. The study was not designed to test a conventional epidemiological hypothesis or estimate causal effects. Methodology/Principal Findings: We developed 45 measurable indicators by adapting the Food and Agriculture Organization Stepwise Approach for the Progressive Control of Brucellosis across five domains: governance, surveillance, laboratory capacity, prevention and control, and communication. The indicators were informed by nine international normative sources and reviewed by three subject-matter experts. We searched PubMed, Scopus, Web of Science, and Google Scholar for scientific literature published between January 2000 and March 2026 and manually screened relevant publicly accessible official documents, including earlier legal and regulatory sources. Seventy-one eligible documents were included. Two reviewers independently scored all indicators using predefined criteria. Exact agreement was 86.7% (39/45), and weighted Cohen's kappa calculated from the original independent pre-consensus scores was 0.84 (95% CI 0.72–0.93). The six disagreements were resolved by consensus. Overall stage classification was determined separately using a rule-based algorithm based on documented program prerequisites rather than aggregated indicator scores. Under the adapted framework, Iran met the minimum documented prerequisites associated with Stage 3. Major implementation or documentation gaps remained in animal identification and traceability, early warning, laboratory partnerships, wildlife and nomadic-population risk management, joint risk assessment, and public reporting. Six interdependent policy priorities were identified. Conclusions/Significance: Iran has established important foundations for brucellosis control, but several integrated and elimination-oriented functions remain incomplete or undocumented. The Stage 3 classification is a framework-based interpretation of publicly available documentary evidence, not an official designation or an independently validated measure of national program performance. The framework may support systematic gap identification and program monitoring, but prospective and external validation is required before its broader application. Author summary: Brucellosis is an infection transmitted from animals to humans that causes chronic illness, livestock losses, and food-safety risks. Although Iran has implemented vaccination, testing, and public-education programs for more than six decades, the disease remains endemic. We developed 45 measurable indicators to examine the documented strengths and gaps of the national control program across governance, surveillance, laboratory capacity, prevention and control, and communication. We reviewed 71 scientific and publicly accessible official documents and assessed each indicator using predefined criteria. We found that Iran has established important foundations for brucellosis control and meets the minimum documented requirements associated with the third stage of the adapted progressive-control framework. However, several systems required for further progress remain incomplete or undocumented, including animal traceability, early warning, laboratory partnerships, wildlife and nomadic-population risk management, coordination between human and animal health authorities, and public reporting. We identified six interconnected policy priorities to address these gaps. Because our assessment relied on publicly available documents, failure to retrieve evidence does not necessarily mean an activity does not exist. The framework may support transparent planning and monitoring but requires further validation before broader use.
SN - 1935-2735
ER -