Performance characteristics and costs of serological tests for brucellosis in a pastoralist community of northern Tanzania
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
Nature scientific Report
Abstract
The control of brucellosis across sub-Saharan Africa is hampered by the lack of standardized testing
and the use of tests with poor performance. This study evaluated the performance and costs of
serological assays for human brucellosis in a pastoralist community in northern Tanzania. Serum
collected from 218 febrile hospital patients was used to evaluate the performance of seven index
tests, selected based on international recommendation or current use. We evaluated the Rose Bengal
test (RBT) using two protocols, four commercial agglutination tests and a competitive enzymelinked
immunosorbent assay (cELISA). The sensitivity, specificity, positive predictive value, negative
predictive value, Youden’s index, diagnostic accuracy, and per-sample cost of each index test were
estimated. The diagnostic accuracy estimates ranged from 95.9 to 97.7% for the RBT, 55.0 to 72.0%
for the commercial plate tests, and 89.4% for the cELISA. The per-sample cost range was $0.69–$0.79
for the RBT, $1.03–$1.14 for the commercial plate tests, and $2.51 for the cELISA. The widely used
commercial plate tests performed poorly and cost more than the RBT. These findings provide evidence
for the public health value of discontinuing the use of commercial agglutination tests for human
brucellosis in Tanzania.
Description
Keywords
serological tests, brucellosis control, pastoralist community, public health, Tanzania