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Brucellosis is among the most prevalent zoonotic infections in Middle Eastern and North African (MENA) countries, critically impacting human and animal health. A comprehensive review of studies on antibiotic susceptibility and therapeutic regimes for brucellosis in ruminants and humans in the MENA region was conducted to evaluate the current therapeutic management in this region. Different scientific databases were searched for peer‐reviewed original English articles published from January 1989 to February 2021. Reports from research organizations and health authorities have been taken into consideration. Brucella melitensis and Brucella abortus have been reported from the majority of MENA countries, suggesting a massive prevalence particularly of B. melitensis across these countries. Several sporadic cases of brucellosis relapse, therapeutic failure, and antibiotic resistance of animal and human isolates have been reported from the MENA region. However, several studies proved that brucellae are still in‐vitro susceptible to the majority of antibiotic compounds and combinations in current recommended World Health Organization (WHO) treatment regimens, for example, levofloxacin, tetracyclines, doxycycline, streptomycin, ciprofloxacin, chloramphenicol, gentamicin, tigecycline, and trimethoprim/sulfamethoxazole. The current review presents an overview on resistance development of brucellae and highlights the current knowledge on effective antibiotics regimens for treating human brucellosis. [ABSTRACT FROM AUTHOR]

Brucellosis is a neglected zoonotic infection with a worldwide distribution and high levels of endemism in some regions, including the Middle East. In Iran, sheep and goats constitute a major part of the livestock population, often kept by small‐scale farmers for their own consumption and economic purposes. This investigation aimed at characterizing the Brucella spp. and biovars circulating in sheep and goats under smallholder farming and their potential spillover across farms. For this purpose, from two randomly selected pastoral districts of Alborz and Fars provinces in Iran, a total of 54 aborted foetuses (38 from sheep and 16 from goats) and 528 blood samples were collected from sheep (n = 435), goats (n = 77), farmers (n = 11) and dogs (n = 5). Then, serological, bacteriological and molecular characterization of Brucella isolates was performed using standard methods. Our results showed the high seroprevalence of brucellosis in pastoral districts of Fars and Alborz provinces reaching 16.3%, 11.7% and 12.7% by using the Rose Bengal plate test (RBPT), serum agglutination test (SAT) and indirect enzyme‐linked immunosorbent assay (iELISA) test, respectively. Furthermore, the results of bacterial culture, conventional biotyping and PCR analyses showed the presence of Brucella melitensis biovar 1 and 2 infections among goat, farmers and dog of the Alborz farms and B. melitensis biovars 1, 2 and 3 among sheep of the Fars farms. Among nine seropositive farmer and dog blood samples (four farmers and five dogs), only three (two farmers and one dog) were positive in both culture and PCR tests. These results stress the need to strengthen screening and control measures in small flocks of small ruminants in Iran that could be the starting point of new outbreaks at the livestock/human interface. The present study also suggests that infected dogs may further maintain the risk of exposure to Brucella pathogens in small farms and beyond. [ABSTRACT FROM AUTHOR]

Since the first official report of the spread of SARS-CoV-2 infections in the city of Qom in mid-February, Iran has become the country most affected by the COVID-19 epidemic in the Middle East. All Iranian provinces are now affected, although to a different extent. The aim of the present study was to evaluate whether the distance from the epicenter of the infection (Qom) or demographic factors such as population density and the ratio of the elderly population are associated with the incidence of COVID-19 in different Iranian provinces. For the purpose of determining whether the distance from the virus epicenter could be associated with the spread of infection, linear regression analysis was performed using STATA 12.0 software. The association of the incidence of COVID-19 with the population density and the ratio of the population over 65 years old in 31 Iranian provinces was also evaluated. According to our results, a strong association was found between the incidence of COVID-19 in Iranian provinces and their respective distance from Qom (p < 0.001; C = -0.68). The incidence of COVID-19 in Iranian provinces was also positively associated with the ratio of the population over 65 years old (p = 0.002; C = 0.53), while no significant association with population density was found (p = 0.39; C = 0.16). These results suggest that the implementation of travel restrictions from highly affected areas to other provinces could considerably reduce the rate of transmission of the disease throughout the country. Also, provinces with a higher proportion of elderly people (over 65) were identified as particularly at risk for the spread of SARS-CoV-2 infections. These results will contribute to better management of the COVID-19 outbreak in Iran, taking into account demographic and geographic characteristics of different provinces. [ABSTRACT FROM AUTHOR]