Skip to main content
Top
Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

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

Authors: Arnold Ezama, Jean-Paul Gonzalez, Samuel Majalija, Francis Bajunirwe

Published in: BMC Public Health | Issue 1/2018

Login to get access

Abstract

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.
Literature
1.
go back to reference Ariza J, Bosilkovski M, Cascio A, Colmenero J, Corbel M. Prospectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med. 2007;4:317.CrossRef Ariza J, Bosilkovski M, Cascio A, Colmenero J, Corbel M. Prospectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med. 2007;4:317.CrossRef
2.
go back to reference Pappas G, Photini P, Nikolaus A, Leonidas C, Epameinondas VT. The new glogal map of human brucellosis. Lancet Infect Dis. 2006;6:91-9. Pappas G, Photini P, Nikolaus A, Leonidas C, Epameinondas VT. The new glogal map of human brucellosis. Lancet Infect Dis. 2006;6:91-9.
3.
go back to reference Nabukenya I, Kaddu-Mulindwa D, Nasinyama GW. Survey of Brucella infection and malaria among abattoir workers in Kampala and Mbarara districts, Uganda. BMC Public Health. 2013;13 Nabukenya I, Kaddu-Mulindwa D, Nasinyama GW. Survey of Brucella infection and malaria among abattoir workers in Kampala and Mbarara districts, Uganda. BMC Public Health. 2013;13
4.
go back to reference Corbel, M., Brucellosis in humans and animals: FAO, OIE, WHO. 2006. Corbel, M., Brucellosis in humans and animals: FAO, OIE, WHO. 2006.
5.
go back to reference Roth F, Zinsstag J, Orkhon D, Chimid-Ochir G, Hutton G. Human health benefits from livestock vaccination for brucellosis: case study. Bull World Health Organ. 2003;81:867–76.PubMed Roth F, Zinsstag J, Orkhon D, Chimid-Ochir G, Hutton G. Human health benefits from livestock vaccination for brucellosis: case study. Bull World Health Organ. 2003;81:867–76.PubMed
6.
go back to reference Miller R, Nakavuma JI, Ssajjakambwe P, Vudriko P, Musisi N, Kaneene JB. The prevalence of brucellosis in cattle, goats and humans in rural Uganda.A comparative study. Transbound Emerg Dis. 2015;6:e197-e210. Miller R, Nakavuma JI, Ssajjakambwe P, Vudriko P, Musisi N, Kaneene JB. The prevalence of brucellosis in cattle, goats and humans in rural Uganda.A comparative study. Transbound Emerg Dis. 2015;6:e197-e210.
7.
go back to reference Ndyomugyenyi R, Magnussen P, Clarke S. Diagnosis and treatment of malaria in peripheral health facilities in Uganda: findings from an area of low transmission in South-Western Uganda. Malaria J. 2007;6(1):39.CrossRef Ndyomugyenyi R, Magnussen P, Clarke S. Diagnosis and treatment of malaria in peripheral health facilities in Uganda: findings from an area of low transmission in South-Western Uganda. Malaria J. 2007;6(1):39.CrossRef
8.
go back to reference Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK. Malaria misdiagnosis in Uganda - implications for policy change. Malaria J. 2009;8:66.CrossRef Nankabirwa J, Zurovac D, Njogu JN, Rwakimari JB, Counihan H, Snow RW, Tibenderana JK. Malaria misdiagnosis in Uganda - implications for policy change. Malaria J. 2009;8:66.CrossRef
9.
10.
go back to reference Shemesh AA, Yagupsky P. Increasing incidence of human brucellosis in southern Israel after the cessation of a veterinarian control campaign. Air Water Borne Dis. 2013;2(2):112. Shemesh AA, Yagupsky P. Increasing incidence of human brucellosis in southern Israel after the cessation of a veterinarian control campaign. Air Water Borne Dis. 2013;2(2):112.
12.
go back to reference Peeling RW, Mabey D. Point-of-care tests for diagnosing infections in the developing world. Clin Microbiol Infect. 2010;16(8):1062–9.CrossRefPubMed Peeling RW, Mabey D. Point-of-care tests for diagnosing infections in the developing world. Clin Microbiol Infect. 2010;16(8):1062–9.CrossRefPubMed
13.
go back to reference Smits HL, Abdoel TH, Solera J, Clavijo E, Díaz R. ImmunochromatographicBrucella-specific immunoglobulin M and G lateral flow assays for rapid serodiagnosis of human brucellosis. Clin Diagn Lab Immunol. 2003;10:1141–6.PubMedPubMedCentral Smits HL, Abdoel TH, Solera J, Clavijo E, Díaz R. ImmunochromatographicBrucella-specific immunoglobulin M and G lateral flow assays for rapid serodiagnosis of human brucellosis. Clin Diagn Lab Immunol. 2003;10:1141–6.PubMedPubMedCentral
14.
go back to reference Ministry of Agriculture Animal Industry and Fisheries. Agriculture for food and income security. In: Agricultural sector development strategy and investment plan 2010/11–2014/15; 2010. Ministry of Agriculture Animal Industry and Fisheries. Agriculture for food and income security. In: Agricultural sector development strategy and investment plan 2010/11–2014/15; 2010.
15.
go back to reference Richard, M., Kavuma.,, Uganda's healthcare system explained, In theguardian. 2009. Richard, M., Kavuma.,, Uganda's healthcare system explained, In theguardian. 2009.
16.
go back to reference Institute for Health Metrics and Evaluation (IHME). Health service provision in Uganda. In: Assessing facility capacity, costs of care, and patient perspectives. Seattle, WA: Institute for Health Metrics and Evaluation; 2014. Institute for Health Metrics and Evaluation (IHME). Health service provision in Uganda. In: Assessing facility capacity, costs of care, and patient perspectives. Seattle, WA: Institute for Health Metrics and Evaluation; 2014.
17.
go back to reference 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(4):950.CrossRef 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(4):950.CrossRef
18.
go back to reference Bennett S, Woods T, Liyanage WM, Smith DL. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q. 1991;44(3):98–106.PubMed Bennett S, Woods T, Liyanage WM, Smith DL. A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q. 1991;44(3):98–106.PubMed
19.
go back to reference Uganda Bureau Of Statistics., National Population and Housing Census 2014. 2014. Uganda Bureau Of Statistics., National Population and Housing Census 2014. 2014.
20.
go back to reference Corbel MJ. Brucellosis in Humans and Animals., F. WHO, OIE. In: Editor; 2006. Corbel MJ. Brucellosis in Humans and Animals., F. WHO, OIE. In: Editor; 2006.
21.
go back to reference Australian Veterinary Emergency Plan. Disease Strategy, in Bovine Brucellosis A.H. Australia: Primary Industries Ministerial Council: Canberra; 2005. Australian Veterinary Emergency Plan. Disease Strategy, in Bovine Brucellosis A.H. Australia: Primary Industries Ministerial Council: Canberra; 2005.
22.
go back to reference Almuneef MA, Memish ZA, Balkhy HH, Alotaibi B, Algoda S, Abbas M, Alsubaie S. Importance of screening household members of acute brucellosis cases in endemic areas. Epidemiol Infect. 2004;132:533–40.CrossRefPubMedPubMedCentral Almuneef MA, Memish ZA, Balkhy HH, Alotaibi B, Algoda S, Abbas M, Alsubaie S. Importance of screening household members of acute brucellosis cases in endemic areas. Epidemiol Infect. 2004;132:533–40.CrossRefPubMedPubMedCentral
23.
go back to reference Research, I.o.E.s.a., Guidelines for the investigation and control of disease outbreaks. 2012, Institute of Environmental Science and Research limited: Porirua, New Zealand. Research, I.o.E.s.a., Guidelines for the investigation and control of disease outbreaks. 2012, Institute of Environmental Science and Research limited: Porirua, New Zealand.
24.
go back to reference OIE (World Organization for Animal Health). Chapter 2.4.3, Bovine Brucellosis. In: OIE, Manual of Diagnostic Tests and Vaccines for Terrestrial Animals, 7th edn. 2012. pp. 1-35. OIE, Paris, France. OIE (World Organization for Animal Health). Chapter 2.4.3, Bovine Brucellosis. In: OIE, Manual of Diagnostic Tests and Vaccines for Terrestrial Animals, 7th edn. 2012. pp. 1-35. OIE, Paris, France.
25.
go back to reference Irmak H, Buzgan T, Evirgen O, Akdeniz H, Demiroz AP. Use of the Brucella IgM and IgG flow assays in the serodiagnosis of human brucellosis in an area endemic for brucellosis. Am J Trop Med Hyg. 2004;70:688–94.PubMed Irmak H, Buzgan T, Evirgen O, Akdeniz H, Demiroz AP. Use of the Brucella IgM and IgG flow assays in the serodiagnosis of human brucellosis in an area endemic for brucellosis. Am J Trop Med Hyg. 2004;70:688–94.PubMed
26.
go back to reference WHO, Brucellosis in humans and animals.:WHO guidance. Geneva, World Health Organization, in Control of communicable diseases manual: an official report of the American Public Health Association, D. HEYMANN, L.,, editor. 2005, World Health Organization/America Public Health Association.: Washington DC. WHO, Brucellosis in humans and animals.:WHO guidance. Geneva, World Health Organization, in Control of communicable diseases manual: an official report of the American Public Health Association, D. HEYMANN, L.,, editor. 2005, World Health Organization/America Public Health Association.: Washington DC.
27.
go back to reference Dean AS, Crump L, Greter H, Schelling E, Zinsstag J. Global Burden of Human Brucellosis: A Systematic Review of Disease Frequency. PLoS Negl.Trop Dis. 2012;6(10):e1865.CrossRefPubMedPubMedCentral Dean AS, Crump L, Greter H, Schelling E, Zinsstag J. Global Burden of Human Brucellosis: A Systematic Review of Disease Frequency. PLoS Negl.Trop Dis. 2012;6(10):e1865.CrossRefPubMedPubMedCentral
28.
29.
go back to reference Ganaa del Pozo JS, Santiago LO, Navarro E, Javier S. Detection of IgM antibrucella antibody in the absence of IgGs: a challenge for the clinical interpretation of Brucella serology. PLoS Negl Trop Dis. 2014;8:12. Ganaa del Pozo JS, Santiago LO, Navarro E, Javier S. Detection of IgM antibrucella antibody in the absence of IgGs: a challenge for the clinical interpretation of Brucella serology. PLoS Negl Trop Dis. 2014;8:12.
30.
go back to reference Centers for Disease Control. Case definitions for infectious conditions. Editor: Public health surveillance; 1997. p. 1–55. Centers for Disease Control. Case definitions for infectious conditions. Editor: Public health surveillance; 1997. p. 1–55.
31.
go back to reference Aranis C, Oporto J, Espinoza M, Riedel L, Perez C. Utilidad de la determinacion de anticuerpos IgG e IgM por ELISA e inmunocaptura en una serie clinica de brucelosis humana. Rev Chil Infect. 2008;25:116–21.CrossRef Aranis C, Oporto J, Espinoza M, Riedel L, Perez C. Utilidad de la determinacion de anticuerpos IgG e IgM por ELISA e inmunocaptura en una serie clinica de brucelosis humana. Rev Chil Infect. 2008;25:116–21.CrossRef
32.
go back to reference WHO, World Malaria Report. 2015, World Health Organization: Geneva p 280. WHO, World Malaria Report. 2015, World Health Organization: Geneva p 280.
33.
go back to reference Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, et al. Variation in malaria transmission transmission intensity in seven sites throughout Uganda. Am j trop Med Hyg. 2006;75:219–25.PubMed Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, et al. Variation in malaria transmission transmission intensity in seven sites throughout Uganda. Am j trop Med Hyg. 2006;75:219–25.PubMed
34.
go back to reference Uganda Bureau of Statistics (UBOS). I.I.I., Uganda Demographic Health Survey 2011. In: Kampala Uganda : UBOS and Calverton. Maryland: ICF International Inc.; 2012. Uganda Bureau of Statistics (UBOS). I.I.I., Uganda Demographic Health Survey 2011. In: Kampala Uganda : UBOS and Calverton. Maryland: ICF International Inc.; 2012.
35.
go back to reference Gómez MC, Nieto JA, Rosa C, Geijo P, Escribano MA. Evaluation of seven tests for the diagnosis of human brucellosis in an endemic area. Clin Vaccine Immunol. 2008;15:1031–3.CrossRefPubMedPubMedCentral Gómez MC, Nieto JA, Rosa C, Geijo P, Escribano MA. Evaluation of seven tests for the diagnosis of human brucellosis in an endemic area. Clin Vaccine Immunol. 2008;15:1031–3.CrossRefPubMedPubMedCentral
Metadata
Title
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
Authors
Arnold Ezama
Jean-Paul Gonzalez
Samuel Majalija
Francis Bajunirwe
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5228-9

Other articles of this Issue 1/2018

BMC Public Health 1/2018 Go to the issue