How do you get the Rose Bengal Test at the point-of-care to diagnose brucellosis in Africa? The importance of a systems approach
How do you get the Rose Bengal Test at the point-of-care to diagnose brucellosis in Africa? The importance of a systems approach
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DOI：
10.1016/j.actatropica.2016.10.004
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发表时间：
2017-01-01
期刊：
影响因子：
2.7
通讯作者：
Bardosh, Kevin L.
中科院分区：
文献类型：
--
作者：
Ducrotoy, Marie J.;Bardosh, Kevin L.
布鲁氏菌病是一种被忽视的主要人畜共患疾病，其在动物和人类中的负担严重不足。人类诊断确定病例，以便在个体水平上治疗疾病。在动物中，诊断是在种群水平上根据适当的控制或根除战略实施的。由于成本、技能和实验室基础设施问题，在撒哈拉以南非洲很少进行分子和细菌学诊断，至少在研究项目之外很少进行。布鲁氏菌病工具箱包含广泛的血清学检测，但不存在分别用于动物和人类的完美检测。众所周知，针对被忽视的人畜共患病的药物和诊断发现很差，而且在开发布鲁氏菌病诊断新工具方面的投资兴趣有限。但现有的工具是否被充分利用了呢？rose Bengal测试（RBT）作为一种有效、实用和非常便宜的测试脱颖而出，适合在资源贫乏的情况下使用。在本文中，我们认为，社会科学或系统方法探索在非洲农村布鲁氏菌病高风险地区提高医疗点诊断能力的可行性，可能是解决诊断不足问题的一步，但这必须与在动物水库源头实施控制措施和治疗人类病例的能力齐头并进。(C) 2016 Elsevier B.V.版权所有
Brucellosis is a major neglected zoonotic disease, whose burden both in animals and humans is severely under-reported. Diagnosis in humans identifies cases in order to treat the disease at the individual level. In animals diagnosis is implemented at the population level in the context of appropriate control or eradication strategies. Molecular and bacteriological diagnosis are rarely undertaken in sub-Saharan Africa, at least outside research projects, due to cost, skills and laboratory infrastructure issues. The brucellosis toolbox contains a wide range of serological tests, but the perfect test for use in animals and humans respectively does not exist. Drug and diagnostic discovery for the neglected zoonoses are notoriously poor, and there is limited investment interest in developing new tools for brucellosis diagnosis. But are current tools being used to their full capacity? The rose Bengal test (RBT) stands out as an efficient, practical and very cheap test adapted for use in the resource-poor context. In this paper, we argue that a social science or system's approach to explore the practicality of improving diagnostic capacity at the point-of care in high-risk brucellosis areas of rural Africa may be a step towards solving the issue of under-diagnosis, but this must go hand-in-hand with implementation of control measures at source in the animal reservoir and capacity to treat human cases. (C) 2016 Elsevier B.V. All rights reserved.