评估乌干达西部一个布鲁氏菌病高度流行的牛养殖人群中的短期布鲁氏菌病：虎红平板凝集试验和 IgM 快速诊断试验的补充应用。
Assessing short evolution brucellosis in a highly brucella endemic cattle keeping population of Western Uganda: a complementary use of Rose Bengal test and IgM rapid diagnostic test.
机构信息
Department of Production and Marketing, Office of the District Veterinary Officer, Sheema District Local Government, P.O. Box 160, Kabwohe, Sheema, Uganda.
Center of Excellence for Emerging and Zoonotic Animal Disease (CEEZAD), Kansas State University, Office Park, 1800 Kimball Ave, Suite 130, Manhattan, Kansas, 66502, United States of America.
出版信息
BMC Public Health. 2018 Mar 5;18(1):315. doi: 10.1186/s12889-018-5228-9.
BACKGROUND
Brucellosis is a worldwide and zoonotic disease often sadly misdiagnosed in endemic areas. Challenges of availability and accessibility of diagnostic tools are common in resource constrained populations where the most vulnerable are found, surveillance and diagnosis are limited too.
METHODS
A cross-sectional study using a simple two stage cluster sampling method was conducted to measure short evolution brucellosis burden among cattle keeping households that are one of the highest risk populations to be exposed to Brucella infection. A total of 216 households were randomly selected from 18 rural villages from the Western Region of Uganda. Household blood samples were tested for Brucella antibodies using the highly sensitive Rose Bengal test (RBT) and IgM ELISA Lateral Flow Assay (LFA).
RESULTS
Among the total tested population, 58.8% did not react with any of the tests, 13.4% reacted with both tests. Among those that reacted with both (N = 29), 62.1% had weak (+ 1) LFA staining, 34.5% had moderate (2+) LFA staining. Altogether, both weak and moderate staining (96.5%) are consistent with sub-acute disease, while only one (3.4%) had strong (3+) LFA staining consistent with acute infection. 19.4% of the samples tested positive only with RBT, consistent with chronic infection, eighteen samples (8.3%) reacted exclusively with IgM LFA.
CONCLUSION
We identified a high prevalence of short evolution brucellosis in the cattle keeping household members. Prevalence of chronic infection diagnosed with RBT only was higher than the prevalence of short evolution brucellosis. IgM LFA results depict possible cases of cross reaction with Salmonella spp., Plasmodium etc. Ultimately, we identified a consistent prevalence of short evolution brucellosis in the cattle keeping household members. Indeed, the use of a combined diagnostic with LFA and RBT is easy and amenable for an active disease surveillance and accurate diagnosis in rural settings.
背景
布鲁氏菌病是一种全球性的人畜共患病，在流行地区常被误诊。在资源有限的人群中，诊断工具的可及性和可用性是常见的挑战，这些人群中最脆弱的人群也受到限制，监测和诊断也受到限制。
方法
采用简单的两阶段聚类抽样方法进行横断面研究，以衡量在暴露于布鲁氏菌感染风险最高的人群之一的养牛家庭中，布鲁氏菌病的短期演变负担。从乌干达西部地区的 18 个农村村庄中随机抽取了 216 户家庭。用高度敏感的孟加拉玫瑰红试验（RBT）和 IgM ELISA 侧向流动测定法（LFA）检测家庭血液样本中的布鲁氏菌抗体。
结果
在总检测人群中，58.8%的人对任何一种检测均无反应，13.4%的人对两种检测均有反应。在对两种检测均有反应的人群中（N=29），62.1%的人 LFA 染色呈弱阳性（+1），34.5%的人 LFA 染色呈中度（2+）。总的来说，弱阳性和中度染色（96.5%）与亚急性疾病一致，只有 1 例（3.4%）的 LFA 染色强阳性（3+）与急性感染一致。19.4%的样本仅用 RBT 检测呈阳性，与慢性感染一致，18 个样本（8.3%）仅用 IgM LFA 反应。
结论
我们发现养牛家庭中存在高流行的布鲁氏菌病短期演变。仅用 RBT 诊断的慢性感染的流行率高于短期演变布鲁氏菌病的流行率。IgM LFA 结果提示可能与沙门氏菌属、疟原虫等发生交叉反应。最终，我们发现养牛家庭中存在一致的短期演变布鲁氏菌病的流行率。事实上，联合使用 LFA 和 RBT 进行诊断既简单又适合于农村地区的主动疾病监测和准确诊断。
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