Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance activities, especially in resource poor settings.Methods: From 2012 to 2017, a total of 179 brain tissue samples collected from different animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) suspected of having died due to rabies were selected and tested using the rapid immunochromatographic kit from BioNote© company and compared to the Gold Standard Fluorescent Antibody test (FAT) for diagnosis of rabies.Results: Among 179 samples examined in this study, there was concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test result were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the gold standard. The positive and negative predicative values were found to be 100% (95% CI:96.7 – 100) and 84% (95% CI: 73.6 – 91.3), respectively. Overall there was 94.41% (95% CI: 90 – 96.9) test agreement (almost perfect agreement) between rapid test and FAT (Kappa value = 0.874).Conclusions: Our results demonstrate the potential value of the rapid test kit for countries with limited diagnostic resources, including Bhutan. The rapid kit’s inability to correctly detect 10 FAT-positive samples (10 out of 179 (5.6%) were false negatives) in our study could have been due to the low viral load in the samples (< 102.0LD50/0.03ml) which could not be detected by the rapid kit as compared with the FAT. The human factor related to the varying experiences of the technicians who performed the test in the field also may have influenced the test result. The rapid test kit is inexpensive, rapid and easy to use in the field or in laboratory setting without the need for special training and can support to enhance rabies surveillance in resource poor countries.

Background: Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. In this study, a total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) relative to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response and enhancing rabies surveillance. Results: Among 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall, there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively. Conclusions: Our finding demonstrated that the rapid test kit (BioNote) can be used for rabies surveillance and confirming clinical case of rabies in animals for making rapid decisions particularly controlling rabies outbreaks in resource poor settings.

Background Rabies kills approximately 59,000 people in the world each year worldwide. Rapid and accurate diagnosis of rabies is important for instituting rapid containment measures and for advising the exposed people for postexposure treatment. The application of a rapid diagnostic tests in the field can greatly enhance disease surveillance and diagnostic activities, especially in resource poor settings. A total of 179 brain tissue samples collected from different rabies suspect animal species (113 dogs, 50 cattle, 10 cats, 3 goats, 2 horses, and 1 bear) were selected and tested using both rapid immunochromatographic kit and the reference standard fluorescent antibody test (FAT). We evaluated the test sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of a rapid antigen detection test kit produced by BioNote, Inc. (Hwaseong-si, Korea) to a FAT for its fit-for-purpose for confirmation of clinical cases of rabies for early response, prevalence of infection (rabies surveillance), freedom for infection and eradication of rabies. ResultsAmong 179 samples examined in this study, there was a concordance in results by the rapid test and FAT in 115 positive samples and 54 negative samples. Test results were discordant in 10 samples which were positive by FAT, but negative (false negative) by rapid kit. The rapid test kit showed a sensitivity of 92% (95% CI: 85.9 – 95.6) and specificity of 100% (95% CI: 93.4 – 100) using FAT as the reference standard. The positive and negative predictive values were found to be 100% (95% CI:96.7 – 100) and 84.4% (95% CI: 73.6 – 91.3), respectively. Overall there was 94.4% (95% CI: 90 – 96.9) test agreement between rapid test and FAT (Kappa value = 0.874) with a positive percent agreement and negative percent agreement of 92 and 100%, respectively.Conclusions Our finding demonstrated that the rapid test kit (BioNote) can be used for confirming clinical case of rabies in animals for making rapid decisions including early medical intervention in human exposure and controlling rabies outbreaks in resource poor settings. Keywords: rabies virus; diagnostic test; fluorescent antibody test; rapid anigen test; rapid immunochromatographic test; Bhutan

The number of farmers' groups (FGs) and cooperatives (Coops) increase annually in Bhutan. However, studies on their performance are limited. Thus, this study (1) examined the performance of agricultural FGs and Coops and (2) determined the association between the performance of FGs and Coops and their selected characteristics in six districts of Eastern Bhutan. The results were generated from the data collected through group interviews of 60 groups (53 FGs and 7 Coops) in early 2020. The cooperative performance index was used to divide groups into three performance levels: (1) early transition to growth, (2) mid-transition to growth, and (3) model groups. The results showed that most groups (62%) were in mid-transition to growth, followed by the early transition to growth and model groups with 20% and 18%, respectively. FGs and Coops performed weakly in areas of management, marketing, and retention of members. The frequency of meetings and the number of literate members were positively correlated with the groups' performance. Overall, this study suggests the requirement of supports in areas of initial institutionalisation of groups, management, marketing, and product diversification to strengthen existing FGs and Coops.