Rose Bengal test: diagnostic yield and use for the rapid diagnosis of human brucellosis in emergency departments in endemic areas

Abstract

The aim of the present study was to analyse the diagnostic yield of the rose Bengal test for the rapid diagnosis of human brucellosis in an emergency department in an area where the disease is endemic. The study included 711 patients diagnosed initially with brucellosis and 270 controls. Brucellosis patients were divided into three groups: group I, individuals with no regular exposure to or history of brucellosis; group II, individuals exposed repeatedly to Brucella infection; and group III, individuals infected with Brucella who had received appropriate treatment during the previous 12 months. Blood cultures were positive for 445 (62.6%) brucellosis patients, while the remaining 266 (37.4%) patients were diagnosed according to clinical and serological criteria. The overall sensitivity of the rose Bengal test was 92.9%. The specificities for groups I, II and III were 94.3%, 91.7% and 76.9%, respectively, with positive likelihood ratios of 16.5, 10.4 and 4.2, respectively. The diagnostic gain after the performance of the rose Bengal test was good or very good in patients with no previous exposure to Brucella or history of brucellosis, but poor in patients who were exposed repeatedly to Brucella or had a history of brucellosis and a low pre-test probability. Use of the rose Bengal test as the sole technique for the diagnosis of brucellosis in endemic areas should be considered very carefully in the context of patients who are exposed repeatedly to Brucella or have a history of brucellosis.

Prevalence of Brucellosis among High Risk Groups in Northern State, Sudan

“…An agreement of 93.4% was found between the RBPT and SAT, indicating that RBPT is an easy to use and costeffective screening test that can provide reliable results in a relatively short time. Similar results were obtained by [28,29], who reported 95.7% and 96% agreement respectively between the RBPT and SAT tests. Other investigators reported 100% agreement with [30] RBPT SAT (≥1:160) 2ME …”

Comparative Evaluation of Native Antigens for the Development of Brucellosis Antibody Detection System

“…RBPT is performed by mixing on a glass plate a drop of RB reagent with an equal volume of serum and agglutination is read after 2-4 min. The sensitivity of RBPT is very high (99%) but the specificity can be disappointingly low (Ruiz-Mesa et al, 2005;Mantur et al, 2006). So, the positive predictive value of the test is low and confirmation is needed by other specific tests.…”

“…The demonstration of antibodies generated against Brucella using serological tests remains a viable alternative to culture, and several serological tests, such as the Rose Bengal plate agglutination test (RBPT) and a standard tube agglutination test (STAT) are the most popular serological tests used in the field for the diagnosis of brucellosis (Morgan et al, 1969;Ruiz-Mesa et al, 2005;Gómez et al, 2008;Chachra et al,2009;Araj, 2010;Al Dahouk et al, 2013). Enzyme-linked immunosorbent assay (ELISA) format offers high sensitivity and specificity in addition to a field-usable format (Jubier-Maurin et al, 2001;Thavaselvam et al, 2010).…”

Seroprevalence of Brucellosis in HIV-Infected Patients in Sanandaj, Iran

“…The prodromal phase of the disease is two to three weeks, but in some patients may last for several months (3,4). Serological methods for brucellosis diagnosis are of great importance to evaluate the disease prevalence in endemic areas (5,6). Infection with human immunodeficiency virus (HIV) leads to cellular and humoral immune deficiency, and the infected individuals become susceptible to various pathogens and opportunistic microbes (7,8).…”