Ekiri Abel B, Kilonzo Christopher, Bird Brian H, VanWormer Elizabeth, Wolking David J, Smith Woutrina A, Masanja Honorati, Kazwala Rudovick R, Mazet Jonna A K
One Health Institute and Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
School of Veterinary Medicine, University of Surrey, Guildford GU2 7AL, UK.
J Trop Med. 2020 Sep 16;2020:6586182. doi: 10.1155/2020/6586182. eCollection 2020.
In endemic African areas, such as Tanzania, spp. cause human febrile illnesses, which often go unrecognized and misdiagnosed, resulting in delayed diagnosis, underdiagnosis, and underreporting. Although rapid and affordable point-of-care tests, such as the Rose Bengal test (RBT), are available, acceptance and adoption of these tests at the national level are hindered by a lack of local diagnostic performance data. To address this need, evidence on the diagnostic performance of RBT as a human brucellosis point-of-care test was reviewed. The review was initially focused on studies conducted in Tanzania but was later extended to worldwide because few relevant studies from Tanzania were identified. Databases including Web of Science, Embase, MEDLINE, and World Health Organization Global Index Medicus were searched for studies assessing the diagnostic performance of RBT (sensitivity and specificity) for detection of human brucellosis, in comparison to the reference standard culture. Sixteen eligible studies were identified and reviewed following screening. The diagnostic sensitivity (DSe) and specificity (DSp) of RBT compared to culture as the gold standard were 87.5% and 100%, respectively, in studies that used suitable "true positive" and "true negative" patient comparison groups and were considered to be of high scientific quality. Diagnostic DSe and DSp of RBT compared to culture in studies that also used suitable "true positive" and "true negative" patient comparison groups but were considered to be of moderate scientific quality varied from 92.5% to 100% and 94.3 to 99.9%, respectively. The good diagnostic performance of RBT combined with its simplicity, quickness, and affordability makes RBT an ideal (or close to) stand-alone point-of-care test for early clinical diagnosis and management of human brucellosis and nonmalarial fevers in small and understaffed health facilities and laboratories in endemic areas in Africa and elsewhere.
在非洲的一些地方病流行区，如坦桑尼亚，某些布鲁氏菌物种会引发人类发热性疾病，这些疾病常常未被识别和误诊，导致诊断延迟、漏诊以及报告不足。尽管有快速且经济实惠的即时检测方法，如玫瑰红试验（RBT），但由于缺乏当地的诊断性能数据，这些检测方法在国家层面的接受度和采用率受到了阻碍。为满足这一需求，对RBT作为人类布鲁氏菌病即时检测方法的诊断性能证据进行了综述。该综述最初聚焦于在坦桑尼亚开展的研究，但后来扩展至全球范围，因为从坦桑尼亚找到的相关研究较少。检索了包括科学网、Embase、医学期刊数据库和世界卫生组织全球医学索引在内的数据库，以查找评估RBT（敏感性和特异性）用于检测人类布鲁氏菌病的诊断性能的研究，并与参考标准培养法进行比较。经过筛选，确定并审查了16项符合条件的研究。在使用了合适的“真阳性”和“真阴性”患者比较组且被认为具有高科学质量的研究中，与作为金标准的培养法相比，RBT的诊断敏感性（DSe）和特异性（DSp）分别为87.5%和100%。在同样使用了合适的“真阳性”和“真阴性”患者比较组但被认为具有中等科学质量的研究中，与培养法相比，RBT的诊断DSe在92.5%至100%之间，诊断DSp在94.3%至99.9%之间。RBT良好的诊断性能，再加上其简单、快速和经济实惠的特点，使其成为非洲及其他地方病流行区小型且人员配备不足的卫生设施和实验室中早期临床诊断和管理人类布鲁氏菌病及非疟疾发热的理想（或接近理想）的独立即时检测方法。
