Objective To analyze the epidemiological characteristics and diagnosis performance of human brucellosis in Henan province and provide evidence for the development of targeted prevention and control strategies.

Methods The incidence data of human brucellosis cases reported in Henan from 2005 to 2025 were obtained from China Information System for Disease Control and Prevention for a descriptive analysis. Joinpoint regression analysis was used to examine trends in incidence rates, and software ArcGIS 10.7 was used to describe the spatial distribution and analyze spatial clustering of human brucellosis.

Results A total of 57,795 human brucellosis cases were reported in Henan during 2005-2025, with an average annual incidence rate of 2.90/100,000. The overall incidence exhibited a significant upward trend (average annual percentage change=16.38%; 95% confidence interval: 14.76%−19.09%; P<0.001), with two incidence peaks in 2015 and 2022, followed by a decline. The disease exhibited marked seasonality, with annual incidence peak occurring during March - August. The patients were mainly men (male to female ratio, 2.46∶1.00), farmers (84.35%), and people aged 40−<70 years (70.03%). Furthermore, linear regression analysis indicated that the median age of patients increased by 0.663 years per year. Spatiotemporal analysis revealed that in 2005, reported cases were mainly distributed in central and northwestern Henan, then spread to central and southern areas, and then eastern area; by 2025, the disease had been reported in all the counties/districts. A noticeable shift in high–high clustering was observed from the north to central Henan, accompanied by a gradual expansion of affected areas. The proportions of acute, sub-acute, and chronic cases were 91.10%, 5.60%, and 3.30%, respectively. The median interval from onset to diagnosis was 17 days (interquartile range: 7−36 days). Among all the patients, 56.67% sought medical care in local hospitals, and 52.99% of the cases were reported by centers for disease control and prevention.

Conclusion The human brucellosis epidemic in Henan is characterized by a wide geographic distribution and a high number of reported cases. Prevention and control efforts should be strengthened for rural middle-aged and elderly men living in areas with high-incidence rates. Improving health education and behavioral intervention are essential for higher public awareness of brucellosis prevention and control.