熱帯病と公衆衛生ジャーナル

概要

Diagnosis of Human Brucellosis

Satish Gupte and Tanveer Kaur

Brucellosis is a worldwide zoonosis with a high degree of morbidity in humans. The disease may be overlooked and misdiagnosed because of the difficult diagnosis and the absence and lack of experience with laboratory testing. As the clinical picture of human brucellosis is fairly non-specific, a definitive diagnosis requires isolation of the causative organism, or the demonstration of the high levels of specific antibodies, or organism specific DNA in samples. Isolation of organism is time-consuming and hazardous, so must be performed by highly skilled personnel. So serological methods are preferred. Advanced serological methods like ELISA, Brucellacapt are more sensitive techniques. Combination of culture and serological test should be used to avoid misdiagnosis. Molecular assays come with high sensitivities and specificities and may reduce diagnostic delays in clinical laboratories. Several PCR based assays have been studied for standardizing them for brucellosis diagnosis. Another rapid, sensitive and inexpensive molecular technique, LAMP has been developed by designing primers specific for Brucella abortus genes. This technique can prove helpful in resource limited settings in developing countries. Highthroughput MLVA-16 genotyping techniques are also being studied and developed for brucella typing for tracing the source of brucellosis infection. This test can be useful for brucella diagnosis and surveillance studies. This review article describes procedures, advantages or limitations of some useful conventional diagnostic techniques to more sophisticated molecular techniques for brucellosis diagnosis.