<p>De-identified dataset used for analyses.</p>

Background
Human brucellosis is a neglected zoonosis that can cause anemia, miscarriage and pre-term birth, yet its burden during pregnancy in Uganda is unknown. This study determined the seroprevalence and associated risk factors for brucellosis among pregnant women at a Tertiary Hospital in Uganda.
Methodology
This cross-sectional study was conducted in the antenatal clinic of Kampala International University Teaching Hospital, western Uganda (September–December 2024). Consecutive participants provided sociodemographic and livestock-exposure data and 5 mL of venous blood was drawn. Sera were screened with the Rose Bengal Plate Test; all reactive samples and 10% of non-reactive samples were confirmed with an indirect IgG/IgM ELISA. Multivariable logistic regression identified factors independently associated with seropositivity with significance set at P < 0.05.
Results
Of 207 enrolled women (median gestation = 24 weeks), 29 were ELISA-confirmed seropositive, giving a prevalence of 14.0% (95% CI 9.2–18.8). Independent risk factors were lack of formal education (adjusted odds ratio [aOR] 4.05, 95% CI 1.02–16.01), consumption of fresh milk or under-cooked meat (aOR 5.70, 95% CI 1.94–16.76), frequent contact with animal manure (aOR 3.29, 95% CI 1.29–8.47) and rearing livestock at home (aOR 3.75, 95% CI 1.36–10.32).
Conclusions
One in seven pregnant women in this mixed livestock–human ecosystem showed evidence of brucellosis, far above the WHO elimination threshold. Integrating RBPT-based screening into routine antenatal care, promoting milk pasteurization and safe meat preparation, improving manure handling and strengthening herd vaccination through One-Health collaboration could reduce maternal infection and adverse pregnancy outcomes in similar smallholder settings.