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Bayesian evaluation of three serological tests for detecting antibodies against brucella spp. among humans in the Northwestern part of Ecuador

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Abstract
Brucellosis is an important but neglected zoonosis that causes serious economic losses both in livestock and human populations. The aim of the present study was to estimate the true prevalence of brucellosis together with diagnostic sensitivity and specificity of three serological tests in humans of the northwestern part of Ecuador using a Bayesian approach adjusted for the dependencies among the multiple tests to avoid any misinterpretation. In addition, the causal agent responsible for human brucellosiswas also identified. Using a total of 3,733 samples collected from humans in this area between 2006 and 2008, the prevalence of human brucellosis and the diagnostic test characteristics of the Rose Bengal fast agglutination test (RBT), Wright's slow agglutination test with ethylenediaminetetraacetic acid disodium salt dehydrate (EDTA) (SAT-EDTA), and indirect ELISA (iELISA) were estimated using a Bayesian approach. The estimated true prevalence of human brucellosis was 1%(credibility interval: 0.4-1.6). The sensitivities of iELISA and RBT were higher than and similar (95.1% and 95.0%, respectively) to those of SAT-EDTA (60.8%). Even though all tests indicated a high specificity (>99.0%), the specificity of SAT-EDTAwas highest (99.9%). The circulating strain in this study area was identified to be Brucella abortus biotype 4 based on culture and microbiological characterization. The RBT and the iELISA are recommended for estimating the true prevalence of human brucellosis and/or for surveillance programs following their high sensitivities and specificities. The proposed strategy supports evidence-based medicine for clinicians and policy-makers to ensure appropriate preventive and control program of brucellosis worldwide.
Keywords
CONDITIONAL DEPENDENCE, DISEASE PREVALENCE, AGGLUTINATION-TEST, DIAGNOSIS, SPECIFICITY, SENSITIVITY, ELISA, SEROPREVALENCE, MELITENSIS, ABORTUS

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MLA
Ron-Román, J., et al. “Bayesian Evaluation of Three Serological Tests for Detecting Antibodies against Brucella Spp. among Humans in the Northwestern Part of Ecuador.” AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, vol. 100, no. 6, 2019, pp. 1312–20, doi:10.4269/ajtmh.18-0622.
APA
Ron-Román, J., Ron-Garrido, L., Abatih, E., Celi-Erazo, M., Vizcaíno-Ordóñez, L., Calva-Pacheco, J., … Saegerman, C. (2019). Bayesian evaluation of three serological tests for detecting antibodies against brucella spp. among humans in the Northwestern part of Ecuador. AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, 100(6), 1312–1320. https://doi.org/10.4269/ajtmh.18-0622
Chicago author-date
Ron-Román, J, L Ron-Garrido, Emmanuel Abatih, M Celi-Erazo, L Vizcaíno-Ordóñez, J Calva-Pacheco, P González-Andrade, et al. 2019. “Bayesian Evaluation of Three Serological Tests for Detecting Antibodies against Brucella Spp. among Humans in the Northwestern Part of Ecuador.” AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE 100 (6): 1312–20. https://doi.org/10.4269/ajtmh.18-0622.
Chicago author-date (all authors)
Ron-Román, J, L Ron-Garrido, Emmanuel Abatih, M Celi-Erazo, L Vizcaíno-Ordóñez, J Calva-Pacheco, P González-Andrade, D Berkvens, W Benítez-Ortíz, J Brandt, D Fretin, and C Saegerman. 2019. “Bayesian Evaluation of Three Serological Tests for Detecting Antibodies against Brucella Spp. among Humans in the Northwestern Part of Ecuador.” AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE 100 (6): 1312–1320. doi:10.4269/ajtmh.18-0622.
Vancouver
1.
Ron-Román J, Ron-Garrido L, Abatih E, Celi-Erazo M, Vizcaíno-Ordóñez L, Calva-Pacheco J, et al. Bayesian evaluation of three serological tests for detecting antibodies against brucella spp. among humans in the Northwestern part of Ecuador. AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE. 2019;100(6):1312–20.
IEEE
[1]
J. Ron-Román et al., “Bayesian evaluation of three serological tests for detecting antibodies against brucella spp. among humans in the Northwestern part of Ecuador,” AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE, vol. 100, no. 6, pp. 1312–1320, 2019.
@article{8642600,
  abstract     = {{Brucellosis is an important but neglected zoonosis that causes serious economic losses both in livestock and human populations. The aim of the present study was to estimate the true prevalence of brucellosis together with diagnostic sensitivity and specificity of three serological tests in humans of the northwestern part of Ecuador using a Bayesian approach adjusted for the dependencies among the multiple tests to avoid any misinterpretation. In addition, the causal agent responsible for human brucellosiswas also identified. Using a total of 3,733 samples collected from humans in this area between 2006 and 2008, the prevalence of human brucellosis and the diagnostic test characteristics of the Rose Bengal fast agglutination test (RBT), Wright's slow agglutination test with ethylenediaminetetraacetic acid disodium salt dehydrate (EDTA) (SAT-EDTA), and indirect ELISA (iELISA) were estimated using a Bayesian approach. The estimated true prevalence of human brucellosis was 1%(credibility interval: 0.4-1.6). The sensitivities of iELISA and RBT were higher than and similar (95.1% and 95.0%, respectively) to those of SAT-EDTA (60.8%). Even though all tests indicated a high specificity (>99.0%), the specificity of SAT-EDTAwas highest (99.9%). The circulating strain in this study area was identified to be Brucella abortus biotype 4 based on culture and microbiological characterization. The RBT and the iELISA are recommended for estimating the true prevalence of human brucellosis and/or for surveillance programs following their high sensitivities and specificities. The proposed strategy supports evidence-based medicine for clinicians and policy-makers to ensure appropriate preventive and control program of brucellosis worldwide.}},
  author       = {{Ron-Román, J and Ron-Garrido, L and Abatih, Emmanuel and Celi-Erazo, M and Vizcaíno-Ordóñez, L and Calva-Pacheco, J and González-Andrade, P and Berkvens, D and Benítez-Ortíz, W and Brandt, J and Fretin, D and Saegerman, C}},
  issn         = {{0002-9637}},
  journal      = {{AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE}},
  keywords     = {{CONDITIONAL DEPENDENCE,DISEASE PREVALENCE,AGGLUTINATION-TEST,DIAGNOSIS,SPECIFICITY,SENSITIVITY,ELISA,SEROPREVALENCE,MELITENSIS,ABORTUS}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1312--1320}},
  title        = {{Bayesian evaluation of three serological tests for detecting antibodies against brucella spp. among humans in the Northwestern part of Ecuador}},
  url          = {{http://dx.doi.org/10.4269/ajtmh.18-0622}},
  volume       = {{100}},
  year         = {{2019}},
}

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