{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:28:00Z","timestamp":1786519680192,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":222,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Microbiology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Brucellosis is a neglected zoonosis with a considerable disease burden in livestock\u2010dependent areas. Khuzestan Province, southwestern Iran, exhibits diverse ecological and agricultural landscapes that may drive heterogeneous transmission. Knowledge of recent epidemiological trends is important for targeted control. We aimed to characterize the temporal and demographic patterns of human brucellosis in Khuzestan from 2017 to 2024, with emphasis on changes observed after 2021. We analyzed aggregated surveillance data for all laboratory\u2010confirmed human brucellosis cases reported in Khuzestan Province between 2017 and 2024. Crude annual incidence rates were calculated using population denominators linearly interpolated from the 2017 census and the 2023 official estimate. Log\u2010linear trend regression, performed using Joinpoint software, estimated the annual percentage changes (APCs) in incidence case counts. Poisson\u2032s regression with population offset quantified period relative risks (RRs) comparing 2022\u20132024 with 2017\u20132021. Chi\u2010square tests assessed temporal shifts in distributions across age groups (15 categories), sex, residence (rural\/urban\/nomadic), and four geographical zones (Northern Highlands, Central Plains, Southern Coastal and Marshland, and Western Borderlands). A total of 3923 cases were reported. Crude incidence remained stable at 7.9\u20138.1 per 100,000 during 2017\u20132019, declined to 6.3\u20137.0 in 2020\u20132021, and then increased sharply to 12.3\u201314.7 in 2022\u20132024 (APC = +10.7\n                    <jats:italic>%<\/jats:italic>\n                    ; 95% CI: 2.2\u201319.9;\n                    <jats:italic>p<\/jats:italic>\n                    = 0.019). Incidence during 2022\u20132024 was 1.66 times higher than during 2017\u20132021 (95% CI: 1.52\u20131.81;\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). The largest relative increases in reported case counts were in adults aged \u2265\u200970 years (APC = +21.1\n                    <jats:italic>%<\/jats:italic>\n                    ; 95% CI: 11.1\u201332.2) and in adults aged 65\u201369 years (+20.0%, 9.9\u201331.1), whereas children aged 0\u20134 years showed no significant change. The male\u2010to\u2010female ratio shifted from 0.88 in 2017 to 1.22 in 2024 (\n                    <jats:italic>p<\/jats:italic>\n                    = 0.032), driven by a significant rise in male cases (APC = +11.5\n                    <jats:italic>%<\/jats:italic>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.011) against a nonsignificant female increase. Rural cases increased significantly (APC = +11.2\n                    <jats:italic>%<\/jats:italic>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.009), accounting for 47%\u201361% of annual cases. The Northern Highlands zone bore 62.7% of total cases (APC = +11.6\n                    <jats:italic>%<\/jats:italic>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.003); the Southern Coastal zone exhibited the steepest relative increase (APC = +15.8\n                    <jats:italic>%<\/jats:italic>\n                    ,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.020). Although statistically significant, changes in composition over time were small in magnitude (Cram\u00e9r\u2032s\n                    <jats:italic>V<\/jats:italic>\n                    = 0.06 \u2212 0.12). Human brucellosis in Khuzestan Province has resurged dramatically since 2021, with a 66% increase in period risk. The epidemiological profile shifted to older adults, males, and people living in rural areas, with marked geographical heterogeneity. The results emphasize the need for targeted vaccination of livestock in high\u2010burden areas (Northern Highlands and Southern Coastal), enhanced surveillance in older age groups, and increased One Health approaches to reverse this trend.\n                  <\/jats:p>","DOI":"10.1155\/ijm\/8935628","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:34:13Z","timestamp":1786516453000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Resurgence of Human Brucellosis in Khuzestan Province, Southwestern Iran: Epidemiological Trends From 2017 to 2024"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-487X","authenticated-orcid":false,"given":"Mehran Varnasseri","family":"Ghandeali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirmansoor Varnasseri","family":"Ghandali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1784-2469","authenticated-orcid":false,"given":"Homayoun","family":"Amiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6455-415X","authenticated-orcid":false,"given":"Nazafarin","family":"Varnasseri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5831-801X","authenticated-orcid":false,"given":"Maryam","family":"Dadar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2909.230052"},{"key":"e_1_2_13_2_2","doi-asserted-by":"crossref","first-page":"1685","DOI":"10.1007\/978-3-031-27164-9_46","volume-title":"Zoonoses: Infections Affecting Humans and Animals","author":"Grace D.","year":"2023"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2017.10.017"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2019.103858"},{"key":"e_1_2_13_5_2","volume-title":"Kh\u016bzest\u0101n (Province, Iran) - Population Statistics, Charts, Map and Location","author":"Iranian Statistical Center","year":"2026"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2017.06.005"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.4103\/jrms.jrms_728_23"},{"key":"e_1_2_13_8_2","first-page":"349","article-title":"A Review of Brucellosis in Iran: Epidemiology, Risk Factors, Diagnosis, Control, and Prevention","volume":"21","author":"Golshani M.","year":"2017","journal-title":"Iranian Biomedical Journal"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.34172\/jrhs.2021.70"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.5812\/archcid-135931"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2023.2290839"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2021.031"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-23182-5"},{"key":"e_1_2_13_14_2","article-title":"Epidemiological Features of Human Brucellosis in Iran (2011-2018) and Prediction of Brucellosis With Data-Mining Models","volume":"19","author":"Bagheri H.","year":"2019","journal-title":"Journal of Research in Health Sciences"},{"key":"e_1_2_13_15_2","first-page":"22","article-title":"Epidemiologic, Demographic, and Clinical Characteristics of Brucellosis in Behbahan County, Southwest Iran, During the Years 2000-2021","volume":"12","author":"Alizadeh-Barzian K.","year":"2024","journal-title":"Jorjani Biomedicine Journal"},{"key":"e_1_2_13_16_2","first-page":"23","article-title":"Epidemiological Study of the Brucellosis in Iran, Andimeshk, 2001-2016","volume":"6","author":"Kashfi M.","year":"2018","journal-title":"Journal of Health Sciences & Surveillance System"},{"key":"e_1_2_13_17_2","article-title":"Epidemiology of Brucellosis in Mazandaran, North of Iran in a Nine-Year Period (2009-2017), Caspian","volume":"15","author":"Seraji M. S.","year":"2024","journal-title":"Journal of Internal Medicine"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.18502\/ijm.v16i5.16797"},{"key":"e_1_2_13_19_2","first-page":"15","article-title":"Spatial Analysis and Distribution of Brucellosis in Urban and Rural Areas (Case Study of Ilam Province), Sustainable Development of Geographical","volume":"4","author":"Amanpour S.","year":"2023","journal-title":"Environment"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2221-1691(13)60121-5"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816002600"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2018.11.028"},{"key":"e_1_2_13_23_2","first-page":"1043","article-title":"Brucellosis: An Infectious Outbreak in China and New Threat to Civilization After COVID-19","volume":"2","author":"Nayak G.","year":"2020","journal-title":"Biotica Research Today"},{"key":"e_1_2_13_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-25304-5"},{"key":"e_1_2_13_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/01652176.2021.1894501"},{"key":"e_1_2_13_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/mrm.0000000000000266"},{"key":"e_1_2_13_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rvsc.2026.106235"},{"key":"e_1_2_13_28_2","doi-asserted-by":"publisher","DOI":"10.1155\/vmi\/7432813"}],"container-title":["International Journal of Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijm\/8935628","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/ijm\/8935628","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/ijm\/8935628","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:34:16Z","timestamp":1786516456000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/ijm\/8935628"}},"subtitle":[],"editor":[{"given":"Swaran J. S.","family":"Flora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/ijm\/8935628"],"URL":"https:\/\/doi.org\/10.1155\/ijm\/8935628","archive":["Portico"],"relation":{},"ISSN":["1687-918X","1687-9198"],"issn-type":[{"value":"1687-918X","type":"print"},{"value":"1687-9198","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8935628"}}