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Brucellosis is a zoonosis of economic and public health concern. While most diagnostic tests for brucellosis can only be performed in the laboratory, the Fluorescence Polarization Assay (FPA) was developed as a rapid point-of-care field test. This pilot project aimed to validate the use of FPA for rapid diagnosis of ruminant brucellosis on the field, and to compare the FPA performance with that of the more commonly used Rose Bengal Test (RBT). Blood samples were first collected from ruminants in a livestock market, and later from a nearby slaughterhouse in Port Bouët, Abidjan, Côte d'Ivoire. Samples collected in the livestock market were processed and tested with the FPA in a central laboratory, while samples collected in the slaughterhouse were processed immediately and the FPA was performed on site. To assess the FPA intra-test agreement, a portion of the serum samples tested at the slaughterhouse were re-tested with the FPA in the laboratory later the same day. To assess inter-test agreement, all serum samples were retested with the RBT. A total of 232 samples were tested with the FPA, 106 and 126 from the livestock market and slaughterhouse, respectively. Of these, 26 tested positive and 39 were doubtful for brucellosis. The FPA was repeated on 28 of the samples collected at the slaughterhouse, and comparison of results indicated a moderate intra-test agreement (Kappa = 0.41). The agreement improved when the doubtful category was treated as negative (Kappa = 0.65), and when cattle were excluded (Kappa = 0.56 to 0.61). The RBT was performed on 229 samples, and of these 10 tested positive. A comparison of FPA and RBT results indicated poor agreement (Kappa = 0.00); this improved to slight when only samples taken at the livestock market and tested in the laboratory were considered (Kappa = 0.14). The FPA did not perform well in tropical field conditions, possibly due to the high ambient temperatures in the slaughterhouse. Moreover, a difference in performance was noted in relation to the species tested, whereby the FPA seemed to perform better on sheep and goat samples, compared to cattle samples. These findings highlight that further adjustments are needed before implementing the FPA on the field.

BACKGROUND One of the most common causes of fever with back pain in India is brucellosis along with tuberculosis infection of the spinal cord and vertebral column. Brucellosis is a multisystem infection with a broad-spectrum of clinical presentations. Its nervous system involvement is known as neurobrucellosis is complication of brucellosis occurring in 0 to 25% and can present as meningitis, encephalitis, myelitis-radiculoneuritis, brain abscess, peripheral neuropathy and psychosis. MATERIALS AND METHODS In this case study, we present a 54-year-old male patient a cattle worker with unexplained back pain. Appropriate blood investigations, CSF analysis and MRI scan were taken towards the cause of the diagnosis. RESULTS CSF analysis showed lymphocyte pleocytosis with agglutination in Rose Bengal test. MRI diagnostic of neurobrucellosis revealed anterosuperior osteophyte inflammations, namely Pedro Pons’ sign or Pom’s sign. CONCLUSION Through this case report, we would like to notify that neurobrucellosis should be considered as one of the differential diagnosis and not to be missed as it is treatable. In such conditions, patient has to be treated with two or more antimicrobials such as rifampicin, co-trimoxazole and doxycycline in order to achieve complete cure rate and to prevent relapse.

Tujuan penelitian adalah untuk mendeteksi adanya antibodi dari Brucella pada ternak sapi perah betina di Banyuwangi menggunakan uji Rose Bengal Test (RBT) untuk uji cepat dan dikonfirmasi dengan menggunakan Complement Fixation Test (CFT). Sebanyak 84 sampel dari 516 sapi perah betina di Banyuwangi, kemudian diambil secara acak. Sampel yang diambil berasal dari serum sapi perah betina. Hasil penelitian ditemukan dua sampel yang dinyatakan positif Brucellosis dengan uji RBT dan CFT. RBT merupakan uji screening yang dapat memberikan hasil positif palsu, dan kemudian dikonfirmasi dengan uji CFT untuk melihat titer hasil vaksin atau infeksi alam. Hasil positif pada uji RBT memiliki hubungan dengan hasil titer CFT karena titer antibodi pada RBT dapat diukur dari derajat aglutinasi yang terbentuk. Hasil seropositif penyakit Brucellosis di Banyuwangi sebesar 2%.

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.

PURPOSE: The aim of this study was to determine the correlation between tear function tests and impression cytology results and the clinical findings in ocular rosacea. METHODS: Patients with a histopathologic and clinical diagnosis of acne rosacea were studied. Ocular examination consisted of best-corrected visual acuity measurement, slitlamp examination, tear break-up time (BUT), basal Schirmer test, and rose Bengal staining. Impression cytology was done two days later. Ocular findings and symptoms were checked and scored. Age-matched controls were assessed using the same parameters. RESULTS: The most frequent symptoms were itching (80%), redness (68%), burning (64%), and photophobia (60%). The most frequent clinical findings were meibomitis (92%), telangiectasis (88%), blepharitis (84%), superficial punctate keratopathy (72%), and hyperemia (60%). Mean tear BUT was 9.6+/-3.1 (SD) seconds (range 5-17 seconds). Mean Schirmer test measured 11.4+/-1.6 mm (SD) (range 8-15 mm). Mean rose Bengal staining scored 1.8+/-0.1. Mean tear BUT, Schirmer test and rose Bengal staining scores were lower in the rosacea group than the control group (p0.05). A significant relation was observed between the stages of impression cytology and the severity of meibomitis (Fisher's test, chi2=9.625, p=0.001). The Schirmer test gave lower results in patients with severe blepharitis (Mann-Whitney U Test, U=180.5, p=0.034). CONCLUSIONS: Early diagnosis prevents serious ocular complications and chronic dry eye in rosacea. We suggest that in addition to tear function tests, rose Bengal staining and impression cytology can be successfully used in the early diagnosis of dry eye and in monitoring medical treatment in ocular rosacea. Meibomian glands play an important role in the pathogenesis of the ocular disease.

El objetivo del presente estudio fue determinar la presencia de Brucella sp. en el ganado bovino de la provincia de Canta, Lima, mediante la detección de anticuerpos en suero a través de la prueba inicial de Rosa de Bengala y la de Fijación de Complemento como prueba confirmatoria. Se procesaron 486 muestras de suero en toda la provincia encontrándose un animal positivo a Brucella sp. en el distrito de Santa Rosa de Quives, lo que significó una prevalencia de 0.21% con intervalo de confianza mínimo de 0.09 y máximo de 0.60%. Los resultados indican una baja prevalencia, lo que permitiría implementar un programa de erradicación de brucelosis bovina en la provincia de Canta., The objective of this study was to determine the presence of Brucella sp. in cattle of the province of Canta, Lima, through the detection of antibodies in blood using the Rose Bengal test and then, the complement fixation test to confirm positive sera. A total of 486 serum samples were analysed and only one from the district of Santa Rosa de Quives was found positive. This indicated that the prevalence was 0.21% (1/486) with a confidence interval of 0.09 till 0.60%. The results showed that the presence of Brucella sp. in the province of Canta was very low, which may allow the implementation of a program for Brucella eradication.

En base a un diagnóstico circunstancial de dos casos de brucelosis en un hato bovino del distrito de Codo del Pozuzo, Huánuco, se llevó a cabo un estudio de prevalencia de Brucella sp. en 5439 bovinos entre abril a junio de 2007. Dos bovinos resultaron positivos a la prueba de Rosa de Bengala, pero negativos a la prueba confirmativa de Fijación del Complemento. El modelo de simulaciones estocásticas de distribución beta mostró una prevalencia de 0.02% con intervalo de confianza mínimo de 0 y máximo de 0.06%., A seroprevalence study on 5439 cattle from April to June 2007 was conducted based on a circumstantial diagnosis of two cases of bovine brucellosis in the district of Codo del Pozuzo, en the region of Huanuco. Two animals resulted positive to the Rose Bengal test but negative to the Complement Fixation test. The beta distribution using a simulation model showed a prevalence of 0.02% with a minimum interval of confidence of 0 and maximum of 0.06%.

European Union (EU) Directive 97/12/EC allows the trade of cattle within the EU of animals originating from an 'officially brucellosis-free herd'. To qualify for this status, a number of different programmes must be implemented. Each EU Member Country is free to decide which procedure to use to qualify herds. The authors conducted a study to compare the merits and costs of testing programmes given in the Directive and of some alternative testing strategies. The effectiveness of testing programmes was evaluated by a Monte Carlo simulation model. Programmes listed in the Directive do not appear to have identical sensitivity and specificity. Simulations of the programmes showed that milk testing may be more effective and efficient than blood testing to identify infected herds. Results indicated that it could be advisable that legislation, rather than defining very detailed procedures both for laboratory tests and testing programmes, should establish minimal requirements in terms of efficacy of testing procedures (i.e. the probability of detecting an infected herd).