The economic burden of brucellosis in Western Iran

Brucellosis, a zoonotic disease caused by Brucella species, remains a major public health and economic challenge in regions dependent on livestock farming. In Iran, particularly in the western provinces, the disease imposes a heavy burden on healthcare systems and households through medical costs and productivity losses. This study quantified the economic burden of brucellosis in western Iran to inform policy and resource allocation.

A cross-sectional cost-of-illness study was conducted among 427 brucellosis patients in Lorestan province. Data on direct medical costs (hospitalization, medications, diagnostics), direct non-medical costs (transportation, accommodation), and indirect costs (productivity losses) were collected using a bottom-up approach. All costs were expressed in 2024 USD, and sensitivity analyses were conducted at 0% and 5% discount rates. The catastrophic health expenditure (CHE) index was used to assess financial hardship.

The mean total cost per patient was 1,060 USD, with direct medical costs representing 73.6% of the total. Hospitalization was the largest component (38%), followed by surgical interventions (26%) and medications (13%). Indirect costs accounted for 18.9% of the total burden. The CHE index reached 66.3%, indicating severe financial strain for affected households. Sensitivity analyses showed notable variability in medical and non-medical cost estimates.

Brucellosis imposes a substantial economic burden in western Iran, reflecting both healthcare and productivity losses. Effective control measures such as livestock vaccination, improved diagnosis, and expanded insurance coverage are essential to reduce financial hardship and support sustainable disease management.