Henk L Smits

..Described PCR assays for typhoid fever have not been validated against bone marrow culture, the gold standard, and their diagnostic utility remains to be established...

..Given the risk for the development of drug resistance and the need for a high degree of participation, close attention should be paid to the monitoring of the coverage and efficacy of the different program components...

..The Peruvian strains were clearly distinct from the East and West Mediterranean groups of B. melitensis genotypes, suggesting that they may constitute a unique Latin American cluster...

..Alertness of medical staff is needed to recognize and diagnose the disease. Awareness of risk groups is needed to take appropriate preventive measures and to accept control measures...

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..Together these characteristics indicate that the Brucella IgM and IgG flow assays are ideal for use in clinical settings in rural and suburban areas in which brucellosis is endemic...

..All of these factors make the test ideal for developing countries and rural settings...

..The reagents have a long shelf life, even at tropical temperatures. Together, these factors make the assay suitable for use even at the peripheral level of a health care system as a rapid screening test for leptospirosis...

..It is also easy to use and does not require special equipment or refrigeration. Therefore the assay is ideal for use in developing countries and rural settings...

..2% for samples collected at a later stage. The specificity was 93.9% and 89.8%, respectively. These characteristics make the test ideal for use in areas where the disease is common and where laboratory support is not routinely available...

..The assay is read after 10 min, and a positive result is obtained when staining of the test line is observed...

..However, as expected, some degree of reactivity was observed when testing selected serum samples that reacted non-specific in reference tests for brucellosis...

..Because of its simplicity, the assay may also be used as a field test in remote areas...

..2% (95% CI, 96-99). The assay is ideal for use as a field test in remote areas and as point-of-care test in hospitals and health care centers that lack the expertise and facilities to perform the more demanding classic serologic tests...

..Thus, Brucella DNA may persist in the serum weeks to months after completion of the standard treatment regimen...

..5% for samples collected between days 7 and 9, and to 84.6% for the samples collected more than 9 days after the onset of illness. Testing of follow-up samples may further improve sensitivity by demonstrating seroconversion...

..This Review summarises current knowledge of the pathogenic mechanisms, new diagnostic advances, therapeutic options, and the situation of developing countries in regard to human brucellosis...

..Although contact with livestock was rare, the consumption of unpasteurized dairy products was reported by almost all patients with brucellosis, their household members, and hospitalized non-brucellosis patients...

..8%. Seven of the 64 Rose Bengal test positive samples reacted weakly (1+) positive in the Brucella IgM/IgG flow assay. No seroconversion was observed. CONCLUSIONS: Brucellosis is not a major cause of morbidity in Binh Thuan province...

..The flow assays are very useful, especially in rural settings where brucellosis is widespread and where well-equipped laboratories to perform the laboratory tests are not readily available...

..The assay utilizes stabilised components and can be stored without the need for refrigeration. These characteristics make the assay ideal in areas where the disease is common and where laboratory support is not routinely available...

..Duration of illness and presence of S. typhi in the blood are major factors that determine severity of disease...

..Under laboratory conditions this test has the advantage of being quick and IgM antibody-specific...

..The agreement was 92%. Application of the flow assays on serum samples collected during a village survey for brucellosis after an outbreak demonstrated their diagnostic potential as field tests...

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..Better access to laboratory testing is needed for the confirmation and management of brucellosis...

..The stability of the reagents of the dipstick and the simplicity of the assay allows its use in places that lack laboratory facilities...

..Use of DNA detection as a marker for treatment success and for the prediction of relapse requires confirmation. In the absence of simple and effective treatment regimens, patient education to promote compliance is essential...

..The assay uses stabilised components that can be stored outside the refrigerator, does not require special equipment, and may be of use in remote health facilities that have no culture facilities...