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Qin S, Lv D, Duan R, Zheng X, Bukai A, Lu X, Duan Q, Yu M, Jing H, Wang X. Case report: A case of brucellosis misdiagnosed as coronavirus disease 2019/influenza in China. Front Public Health 2023; 11:1186800. [PMID: 37724314 PMCID: PMC10505428 DOI: 10.3389/fpubh.2023.1186800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/14/2023] [Indexed: 09/20/2023] Open
Abstract
Brucellosis is an important zoonosis and a multisystem disease. The signs and symptoms of brucellosis are not specific. In the clinical, brucellosis is often ignored and misdiagnosed. We report a case of brucellosis who was misdiagnosed as coronavirus disease 2019 (COVID-19)/influenza and received delayed treatment during strict COVID-19 control. The neglect of other diseases due to COVID-19 and empirical diagnosis and treatment by medical staff are part of the reasons for misdiagnosis. Otherwise, the normal erythrocyte sedimentation rate (ESR), increased white blood cell count (WBC), and increased neutrophil count (NEUT) of this patient was also a cause of misdiagnosis, which is an important reminder for diagnosis. For patients with the unknown origin of fever and other symptoms related to brucellosis, especially those from endemic areas of brucellosis, brucellosis screening is a priority item, and grassroots doctors should be vigilant and standardize the diagnosis and treatment based on epidemiology history, clinical manifestation, and laboratory tests according to the diagnostic criteria of brucellosis.
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Affiliation(s)
- Shuai Qin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongyue Lv
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ran Duan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojin Zheng
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Asaiti Bukai
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Xinmin Lu
- Akesai Kazak Autonomous County Center for Disease Control and Prevention, Jiuquan, China
| | - Qun Duan
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mingrun Yu
- Taizhou Center for Disease Control and Prevention, Taizhou, China
| | - Huaiqi Jing
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Dong SB, Xiao D, Liu JY, Bi HM, Zheng ZR, Wang LD, Yang XW, Tian GZ, Zhao HY, Piao DR, Xing ZF, Jiang H. Fluorescence polarization assay improves the rapid detection of human brucellosis in China. Infect Dis Poverty 2021; 10:46. [PMID: 33789762 PMCID: PMC8011177 DOI: 10.1186/s40249-021-00834-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/24/2021] [Indexed: 12/03/2022] Open
Abstract
Background Brucellosis is an infectious-allergic zoonotic disease caused by bacteria of the genus Brucella. Early diagnosis is the key to preventing, treating, and controlling brucellosis. Fluorescence polarization immunoassay (FPA) is a new immunoassay for relatively rapid and accurate detection of antibodies or antigens based on antigen–antibody interaction. However, there is no report on FPA-based detection of human brucellosis in China. Therefore, this study is to evaluate the value of FPA for the diagnosis of human brucellosis in China. Methods We recruited 320 suspected brucellosis cases who had the clinical symptoms and epidemiological risk factors between January and December, 2019. According to China Guideline for Human Brucellosis Diagnosis, the Rose Bengal test (RBT) was used for the screening test, and the serum agglutination test (SAT) was used as the confirmatory test. Brucellosis was confirmed only if the results of both tests were positive. Additionally, FPA and enzyme linked immune sorbent assay (ELISA) were compared with SAT, and their sensitivity, specificity, coincidence rate and consistency coefficient (Kappa value) as diagnostic tests were analyzed individually and in combination. The optimal cut-off value of FPA was also determined using the receiver operator characteristic (ROC) curve. Results The optimum cut-off value of FPA was determined to be 88.5 millipolarization (mP) units, with a sensitivity of 94.5% and specificity of 100.0%. Additionally, the coincidence rate with the SAT test was 96.6%, and the Kappa value (0.9) showed excellent consistency. The sensitivity and specificity of FPA and ELISA combined were higher at 98.0% and 100.0% respectively. Conclusions When the cut-off value of FPA test is set at 88.5 mP, it has high value for the diagnosis of brucellosis. Additionally, when FPA and ELISA are combined, the sensitivity of diagnosis is significantly improved. Thus, FPA may have potential in the future as a diagnostic method for human brucellosis in China. Graphic abstract ![]()
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Affiliation(s)
- Shuai-Bing Dong
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.,Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Di Xiao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing-Yao Liu
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Hui-Mei Bi
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Zun-Rong Zheng
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Li-Da Wang
- General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, China
| | - Xiao-Wen Yang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guo-Zhong Tian
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hong-Yan Zhao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dong-Ri Piao
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhi-Feng Xing
- Heilongjiang Provincial Centre for Disease Control and Prevention, Harbin, China
| | - Hai Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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3
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Lukambagire AS, Mendes ÂJ, Bodenham RF, McGiven JA, Mkenda NA, Mathew C, Rubach MP, Sakasaka P, Shayo DD, Maro VP, Shirima GM, Thomas KM, Kasanga CJ, Kazwala RR, Halliday JEB, Mmbaga BT. Performance characteristics and costs of serological tests for brucellosis in a pastoralist community of northern Tanzania. Sci Rep 2021; 11:5480. [PMID: 33750848 PMCID: PMC7943594 DOI: 10.1038/s41598-021-82906-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/21/2021] [Indexed: 01/31/2023] Open
Abstract
The control of brucellosis across sub-Saharan Africa is hampered by the lack of standardized testing and the use of tests with poor performance. This study evaluated the performance and costs of serological assays for human brucellosis in a pastoralist community in northern Tanzania. Serum collected from 218 febrile hospital patients was used to evaluate the performance of seven index tests, selected based on international recommendation or current use. We evaluated the Rose Bengal test (RBT) using two protocols, four commercial agglutination tests and a competitive enzyme-linked immunosorbent assay (cELISA). The sensitivity, specificity, positive predictive value, negative predictive value, Youden's index, diagnostic accuracy, and per-sample cost of each index test were estimated. The diagnostic accuracy estimates ranged from 95.9 to 97.7% for the RBT, 55.0 to 72.0% for the commercial plate tests, and 89.4% for the cELISA. The per-sample cost range was $0.69-$0.79 for the RBT, $1.03-$1.14 for the commercial plate tests, and $2.51 for the cELISA. The widely used commercial plate tests performed poorly and cost more than the RBT. These findings provide evidence for the public health value of discontinuing the use of commercial agglutination tests for human brucellosis in Tanzania.
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Affiliation(s)
- AbdulHamid S Lukambagire
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.
| | - Ângelo J Mendes
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Rebecca F Bodenham
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - John A McGiven
- OIE/FAO Brucellosis Reference Laboratory, Department of Bacteriology, Animal and Plant Health Agency, Surrey, UK
| | | | - Coletha Mathew
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Matthew P Rubach
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Duke Global Health Institute, Durham, NC, USA
| | - Philoteus Sakasaka
- Duke Global Health Institute, Durham, NC, USA
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
| | | | - Venance P Maro
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Gabriel M Shirima
- The Nelson Mandela African Institution for Science and Technology, Arusha, Tanzania
| | - Kate M Thomas
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Christopher J Kasanga
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Rudovick R Kazwala
- College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Blandina T Mmbaga
- Kilimanjaro Christian Medical Center, Moshi, Tanzania
- Duke Global Health Institute, Durham, NC, USA
- Kilimanjaro Clinical Research Institute-Biotechnology Laboratory, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
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4
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Jiang H, Feng L, Lu J. Updated Guidelines for the Diagnosis of Human Brucellosis - China, 2019. China CDC Wkly 2020; 2:487-489. [PMID: 34594685 PMCID: PMC8393123 DOI: 10.46234/ccdcw2020.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/27/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hai Jiang
- 1 State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lan Feng
- 1 State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinxing Lu
- 1 State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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Falzon LC, Traoré S, Kallo V, Assamoi JB, Bonfoh B, Schelling E. Evaluation of the Fluorescence Polarization Assay as a Rapid On-Spot Test for Ruminant Brucellosis in Côte d'Ivoire. Front Vet Sci 2019; 6:287. [PMID: 31552280 PMCID: PMC6746889 DOI: 10.3389/fvets.2019.00287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 08/13/2019] [Indexed: 12/30/2022] Open
Abstract
Brucellosis is a zoonosis of economic and public health concern. While most diagnostic tests for brucellosis can only be performed in the laboratory, the Fluorescence Polarization Assay (FPA) was developed as a rapid point-of-care field test. This pilot project aimed to validate the use of FPA for rapid diagnosis of ruminant brucellosis on the field, and to compare the FPA performance with that of the more commonly used Rose Bengal Test (RBT). Blood samples were first collected from ruminants in a livestock market, and later from a nearby slaughterhouse in Port Bouët, Abidjan, Côte d'Ivoire. Samples collected in the livestock market were processed and tested with the FPA in a central laboratory, while samples collected in the slaughterhouse were processed immediately and the FPA was performed on site. To assess the FPA intra-test agreement, a portion of the serum samples tested at the slaughterhouse were re-tested with the FPA in the laboratory later the same day. To assess inter-test agreement, all serum samples were retested with the RBT. A total of 232 samples were tested with the FPA, 106 and 126 from the livestock market and slaughterhouse, respectively. Of these, 26 tested positive and 39 were doubtful for brucellosis. The FPA was repeated on 28 of the samples collected at the slaughterhouse, and comparison of results indicated a moderate intra-test agreement (Kappa = 0.41). The agreement improved when the doubtful category was treated as negative (Kappa = 0.65), and when cattle were excluded (Kappa = 0.56 to 0.61). The RBT was performed on 229 samples, and of these 10 tested positive. A comparison of FPA and RBT results indicated poor agreement (Kappa = 0.00); this improved to slight when only samples taken at the livestock market and tested in the laboratory were considered (Kappa = 0.14). The FPA did not perform well in tropical field conditions, possibly due to the high ambient temperatures in the slaughterhouse. Moreover, a difference in performance was noted in relation to the species tested, whereby the FPA seemed to perform better on sheep and goat samples, compared to cattle samples. These findings highlight that further adjustments are needed before implementing the FPA on the field.
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Affiliation(s)
- Laura C Falzon
- Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom.,International Livestock Research Institute, Nairobi, Kenya.,Veterinary Public Health Institute, University of Bern, Bern, Switzerland
| | - Sylvain Traoré
- Université Pelefero Gon Coulibaly de Korhogo, Korhogo, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Vessaly Kallo
- Direction des Services Vétérinaires de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | | | - Bassirou Bonfoh
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Swiss Tropical and Public Health Institute, Basel, Switzerland
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Christoforidou S, Boukouvala E, Zdragas A, Malissiova E, Sandalakis V, Psaroulaki A, Petridou E, Tsakos P, Ekateriniadou L, Hadjichristodoulou C. Novel diagnostic approach on the identification ofBrucella melitensisGreek endemic strains-discrimination from the vaccine strain Rev.1 by PCR-RFLP assay. Vet Med Sci 2018. [PMCID: PMC6090408 DOI: 10.1002/vms3.99] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Despite the intensive implementation of control programmes goat, sheep and human brucellosis remains endemic in Greece. As the discrimination between field endemic strains and vaccine strain Rev.1 is not feasible, it is essential to develop new diagnostic tools for brucellosis diagnosis. Moreover, effective disease control requires enhanced epidemiological surveillance in both humans and animals including robust laboratory support. Two new multiplex (duplex) polymerase chain reactions (PCRs) were developed and the results were compared with those obtained by real‐time PCR and bacteriological biotyping. A total of 71 Brucella spp. Greek endemic strains were identified at species and biovar level, using both molecular and conventional techniques. Their discrimination from the vaccine strain Rev.1 was achieved, using polymerase chain reaction‐restriction fragment length polymorphism assay (PCR‐RFLP). All 71 strains were identified as Brucella melitensis by multiplex PCR as well as by real‐time PCR and conventional biotyping. Sixty‐two (87.3%) out of 71 strains were identified as B. melitensis biovar 3, eight (11,3%) strains as biovar 1 and only one (1,4%) as biovar 2. Digestion with PstI restriction enzyme revealed that all strains were field endemic strains, as they gave different patterns from the vaccine strain Rev.1. Brucella melitensis biovar 3 appears to be the predominant type in Greece. The novel multiplex PCR produced results concordant to ones obtained by real‐time PCR and conventional biotyping. This technique could support and facilitate the surveillance of Brucellosis in Greece contributing in the control of the disease.
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Affiliation(s)
- Sofia Christoforidou
- Veterinary Research Institute of Thessaloniki; Hellenic Agricultural Organization DEMETER (former NAGREF); Thessaloniki Greece
- Laboratory of Hygiene and Epidemiology; Faculty of Medicine; School of Health Sciences; University of Thessaly; Larissa Greece
| | - Evridiki Boukouvala
- Veterinary Research Institute of Thessaloniki; Hellenic Agricultural Organization DEMETER (former NAGREF); Thessaloniki Greece
| | - Antonios Zdragas
- Veterinary Research Institute of Thessaloniki; Hellenic Agricultural Organization DEMETER (former NAGREF); Thessaloniki Greece
| | - Eleni Malissiova
- Dairy Laboratory; Food Technology Department; Technological Educational Institute of Thessaly; Thessaly Greece
| | - Vassilios Sandalakis
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine; School of Medicine; University of Crete; Heraklion Greece
| | - Anna Psaroulaki
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine; School of Medicine; University of Crete; Heraklion Greece
| | - Evanthia Petridou
- Laboratory of Microbiology; Faculty of Veterinary Medicine; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - Panagiotis Tsakos
- Ministry of Rural Development and Food; Directorate of Veterinary Centre of Thessaloniki; Laboratory of Microbiology & Infectious Diseases; Thessaloniki Greece
| | - Loukia Ekateriniadou
- Veterinary Research Institute of Thessaloniki; Hellenic Agricultural Organization DEMETER (former NAGREF); Thessaloniki Greece
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology; Faculty of Medicine; School of Health Sciences; University of Thessaly; Larissa Greece
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Despotopoulos S, Akinosoglou K, Tzimas T, Akritidis N, Gogos C. Diagnosis of neurobrucellosis in resource-limited real-world settings: A case-series of 8 patients. J Neurol Sci 2017; 379:293-295. [DOI: 10.1016/j.jns.2017.06.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/11/2017] [Accepted: 06/15/2017] [Indexed: 11/27/2022]
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8
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Rahman AKMA, Saegerman C, Berkvens D. Latent class evaluation of three serological tests for the diagnosis of human brucellosis in Bangladesh. Trop Med Health 2016; 44:32. [PMID: 27729827 PMCID: PMC5048465 DOI: 10.1186/s41182-016-0031-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 08/10/2016] [Indexed: 11/12/2022] Open
Abstract
Background A Bayesian latent class evaluation was used to estimate the true prevalence of brucellosis in livestock farmers and patients with prolonged pyrexia (PP) and to validate three conditionally dependent serological tests: indirect ELISA (iELISA), Rose Bengal Test (RBT), and standard tube agglutination (STAT). A total of 335 sera from livestock farmers and 300 sera from PP patients were investigated. Results The true prevalence of brucellosis in livestock farmers and PP patients was estimated to be 1.1 % (95 % credibility interval (CrI) 0.1–2.8) and 1.7 % (95 % CrI 0.2–4.1), respectively. Specificities of all tests investigated were higher than 97.8 % (95 % CrI 96.1–99.9). The sensitivities varied from 68.1 % (95 % CrI 54.5–80.7) to 80.6 % (95 % CrI 63.6–93.8). The negative predictive value of all the three tests in both populations was very high and more than 99.5 % (95 % CrI 98.6–99.9). The positive predictive value (PPV) of all three tests varied from 27.9 % (95 % CrI 3.6–62.0) to 36.3 % (95 % CrI 5.6–70.5) in livestock farmers and 39.8 % (95 % CrI 6.0–75.2) to 42.7 % (95 % CrI 6.4–83.2) in patients with PP. The highest PPV were 36.3 % for iELISA and 42.7 % for RBT in livestock farmers and pyrexic patients, respectively. Conclusions In such a low prevalence scenario, serology alone does not help in diagnosis and thereby therapeutic decision-making. Applying a second test with high specificity and/or testing patients having history of exposure with known risk factors and/or testing patients having some clinical signs and symptoms of brucellosis may increase the positive predictive value of the serologic tests. Electronic supplementary material The online version of this article (doi:10.1186/s41182-016-0031-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A K M A Rahman
- Department of Medicine, Bangladesh Agricultural University, Mymensingh, 2200 Bangladesh ; Research Unit of Epidemiology and Risk Analysis applied to the Veterinary Sciences (UREAR-ULg), Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium ; Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - C Saegerman
- Research Unit of Epidemiology and Risk Analysis applied to the Veterinary Sciences (UREAR-ULg), Department of Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - D Berkvens
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
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Vyas SS, Jadhav SV, Majee SB, Shastri JS, Patravale VB. Development of immunochromatographic strip test using fluorescent, micellar silica nanosensors for rapid detection of B. abortus antibodies in milk samples. Biosens Bioelectron 2015; 70:254-60. [PMID: 25829223 DOI: 10.1016/j.bios.2015.03.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 02/02/2023]
Abstract
Presence of bacteria such as Brucella spp. in dairy products is an immense risk to public health. Point of care immunoassays are rapid in that they can quickly screen various samples in a relatively short amount of time, are sensitive, specific and offer a great advantage in accurate and fast diagnosis of infectious diseases. We have fabricated a point of care rapid diagnostic assay that employs fluorescent, micellar silica nanosensors capable of specifically detecting Brucella IgG antibodies in milk samples of afflicted animals. Currently, point of care detection assays are not commercially available for field testing of farm animals using milk samples. The nanosensing allows precise detection of antibodies with low sample volumes (50 μl). We demonstrate recognition of B. abortus antibodies through capture by fluorescent silica nanosensors using spiked and raw milk samples validated by ELISA and PCR. The test results are accurate and repeatable with high sensitivity and specificity, and a short assay time of 10 min for antigenic recognition and do not require any sample processing procedures such as isolation and separation. Additionally, well defined antigenic components and surface biomarkers of various disease causing microbes can be broadly incorporated within the purview of this technology for accurate and rapid detection of suspected bovine pathological conditions, and can largely enable rapid field testing that can be implemented in farms and food industry.
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Affiliation(s)
- Swati S Vyas
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga, Mumbai 400019, India
| | - Sushma V Jadhav
- Department of Microbiology, Bombay Veterinary College, Parel, Mumbai 400012, India
| | - Sharmila B Majee
- Department of Microbiology, Bombay Veterinary College, Parel, Mumbai 400012, India
| | - Jayanthi S Shastri
- Topiwala National Medical College & B. Y. L. Nair Charitable Hospital, Dr. A. L. Nair Road, Mumbai 400008, India
| | - Vandana B Patravale
- Department of Pharmaceutical Sciences and Technology, Institute of Chemical Technology, Matunga, Mumbai 400019, India.
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Dürr S, Bonfoh B, Schelling E, Kasymbekov J, Doherr MG, Toktobaev N, Schueth T, Zinsstag J. Bayesian estimation of the seroprevalence of brucellosis in humans and livestock in Kyrgyzstan. REV SCI TECH OIE 2014; 32:801-15. [PMID: 24761732 DOI: 10.20506/rst.32.2.2215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Kyrgyzstan reported 77.5 new cases of human brucellosis per 100,000 inhabitants in 2007, which is one of the highest incidences in the world. However, because this number is based on official records, it is very likely that the incidence is underreported. The diagnostic tests most commonly used in Kyrgyzstan are the Rose Bengal test in ruminants and the Huddleson test in humans. The sensitivity and specificity of these tests have never been evaluated under field conditions in Kyrgyzstan, where the strains circulating in livestock and humans are unknown. Therefore, a representative national cross-sectional serological study was undertaken in humans, cattle, sheep and goats to assess the true seroprevalence and to compare different serologicaltests. In the year of study (2006), few animals were vaccinated against brucellosis in Kyrgyzstan. A total of 5,229 livestock sera and 1,777 human sera from three administrative regions were collected during spring 2006 and submitted to a range of serological tests. The true seroprevalence of brucellosis, estimated using Bayesian methodology, was 7% (95% credibility interval 4%-9%) in humans, 3% (1%-5%) in cattle, 12% (7%-23%) in sheep and 15% (7%-30%) in goats. The Rose Bengal test was confirmed as a useful screening test in livestock and humans, although its sensitivity was lower than that of other tests. The estimates of specificity of all tests were significantly higher than those for sensitivity. The high seroprevalence of brucellosis in humans, cattle and small ruminants in Kyrgyzstan was confirmed. Bayesian statistical approaches were demonstrated to be useful for simultaneously deriving test characteristics and true prevalence estimates in the absence of a gold standard.
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Al Dahouk S, Nöckler K. Implications of laboratory diagnosis on brucellosis therapy. Expert Rev Anti Infect Ther 2012; 9:833-45. [PMID: 21810055 DOI: 10.1586/eri.11.55] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Brucellosis is a worldwide zoonosis with a huge economic impact on animal husbandry and public health. The diagnosis of human brucellosis can be protracted because the disease primarily presents as fever of unknown origin with unspecific clinical signs and symptoms. The isolation rate of the fastidious etiologic agent from blood cultures is low, and therefore laboratory diagnosis is mainly based on serologic and molecular testing. However, seronegative brucellosis patients have been described, and antibody titers of diagnostic significance are difficult to define. Whether the molecular detection of Brucella DNA in clinical samples should be followed by long-term antibiotic treatment or not is also a matter of debate. The aim of this article is to review and discuss the implications of laboratory test results in the diagnosis of human brucellosis on disease therapy.
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Affiliation(s)
- Sascha Al Dahouk
- Federal Institute for Risk Assessment, Hygiene and Microbiology, Diedersdorfer Weg 1, D-12277 Berlin, Germany.
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Díaz R, Casanova A, Ariza J, Moriyón I. The Rose Bengal Test in human brucellosis: a neglected test for the diagnosis of a neglected disease. PLoS Negl Trop Dis 2011; 5:e950. [PMID: 21526218 PMCID: PMC3079581 DOI: 10.1371/journal.pntd.0000950] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Accepted: 12/23/2010] [Indexed: 11/19/2022] Open
Abstract
Brucellosis is a highly contagious zoonosis affecting livestock and human beings. The human disease lacks pathognomonic symptoms and laboratory tests are essential for its diagnosis. However, most tests are difficult to implement in the areas and countries were brucellosis is endemic. Here, we compared the simple and cheap Rose Bengal Test (RBT) with serum agglutination, Coombs, competitive ELISA, Brucellacapt, lateral flow immunochromatography for IgM and IgG detection and immunoprecipitation with Brucella proteins. We tested 208 sera from patients with brucellosis proved by bacteriological isolation, 20 contacts with no brucellosis, and 1559 sera of persons with no recent contact or brucellosis symptoms. RBT was highly sensitive in acute and long evolution brucellosis cases and this related to its ability to detect IgM, IgG and IgA, to the absence of prozones, and to the agglutinating activity of blocking IgA at the pH of the test. RBT was also highly specific in the sera of persons with no contact with Brucella. No test in this study outperformed RBT, and none was fully satisfactory in distinguishing contacts from infected patients. When modified to test serum dilutions, a diagnostic titer >4 in RBT resulted in 87.4% sensitivity (infected patients) and 100% specificity (contacts). We discuss the limitations of serological tests in the diagnosis of human brucellosis, particularly in the more chronic forms, and conclude that simplicity and affordability of RBT make it close to the ideal test for small and understaffed hospitals and laboratories.
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Affiliation(s)
- Ramón Díaz
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
| | - Aurora Casanova
- Departamento de Microbiología, Hospital Universitari de Bellvitge, Universidad de Barcelona (IDIBELL), Barcelona, Spain
| | - Javier Ariza
- Departamento de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, Universidad de Barcelona (IDIBELL), Barcelona, Spain
| | - Ignacio Moriyón
- Departamento de Microbiología y Parasitología, Facultad de Medicina, Universidad de Navarra, Pamplona, Spain
- * E-mail:
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Marcotty T, Matthys F, Godfroid J, Rigouts L, Ameni G, Gey van Pittius N, Kazwala R, Muma J, van Helden P, Walravens K, de Klerk LM, Geoghegan C, Mbotha D, Otte M, Amenu K, Abu Samra N, Botha C, Ekron M, Jenkins A, Jori F, Kriek N, McCrindle C, Michel A, Morar D, Roger F, Thys E, van den Bossche P. Zoonotic tuberculosis and brucellosis in Africa: neglected zoonoses or minor public-health issues? The outcomes of a multi-disciplinary workshop. ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2010; 103:401-11. [PMID: 19583911 DOI: 10.1179/136485909x451771] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Late in 2007, veterinary, medical and anthropological professionals from Europe and Africa met in a 2-day workshop in Pretoria, South Africa, to evaluate the burden, surveillance and control of zoonotic tuberculosis and brucellosis in sub-Saharan Africa. Keynote presentations reviewed the burden of these diseases on human and livestock health, the existing diagnostic tools, and the available control methods. These presentations were followed by group discussions and the formulation of recommendations. The presence of Mycobacterium bovis and Brucella spp. in livestock was considered to be a serious threat to public health, since livestock and animal products are the only source of such infections in human beings. The impact of these pathogens on human health appears to be relatively marginal, however, when compared with Mycobacterium tuberculosis infections and drug resistance, HIV and malaria. Appropriate diagnostic tools are needed to improve the detection of M. bovis and Brucella spp. in humans. In livestock, the 'test-and-slaughter' approach and the pasteurization of milk, which have been used successfully in industrialized countries, might not be the optimal control tools in Africa. Control strategies should fit the needs and perceptions of local communities. Improved intersectoral and international collaboration in surveillance, diagnosis and control, and in the education of medical and veterinary personnel, are advocated.
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Affiliation(s)
- T Marcotty
- Department of Animal Health, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
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