Shakeela Anjum (2006-VA-172)

Seroprevalence Of Brucellosis In Pregnant And Aborted Women Of Rural And Urban Areas In Three Selected Districts Of Punjab Pakistan - 2015. - 56p.;

Brucellosis is an important zoonotic disease of animals and human. According to OIE
(Office International des Epizooties), it is the second most important zoonotic disease in the
world after rabies Brucellosis is more common in countries with Poorly standardized animal
and public health programme. Human Brucellosis caused by B. abortus, B. abortus are small,
non-motile, aerobic, facultative intracellular, Gram-negative cocobacilli.
The symptoms of human brucellosis are undulant fever, headache, weakness, body
pain, and sometimes endocarditis, orchitis, or arthritis may develop. Prolonged use of
combination of antibiotics and human vaccine is main control measure strategies for human
brucellosis. This disease is under investigated and hence people are ignorant of this insidious
problem. Serological surveillance is a good and cheap tool to diagnose this problem. There is
also need to know that which diagnostic antigen (Pakistani or French) is more sensitive and
specific from disease eradication and control point of view. Unfortunately annual incidence
of brucellosis in whole Pakistan is unknown but they are expected above 2 per 100,000
people. The hypothesis of present study was that brucellosis is considered to be endemic in
Pakistan but there is no data available about seroprevalence of brucellosis in pregnant,
aborted, rural and urban women with different risk factors in Pakistan.
In present study sero-screening of total 199 serum samples of pregnant and women
presenting with abortions from district Jhang, district Chinoit and district Faisalabad. Test
was performed on 199 samples which showed 40 (20%) positives by RBPT (Pakistan) and 42
(21%) positives by RBPT (France) (Table 4.4). While the indirect modified ELISA showing
5 (2.5%) positive samples. All sera tested positives (5) with modified i-ELIA were also tested
positives with another specific and highly expensive ELISA (Verion Serion) at OIE reference
Laboratory for brucellosis, Germany. Prevalence data was analyzed by chi square test
using SPSS version 20 Software (Apache License, USA) to find out correlation between risk
factors and brucellosis prevalence.
Risk factors such as consumption of raw milk, contact with animals, and symptoms
were significant. In our opinion, indirect modified ELISA is more sensitive than RBPT
(Pakistan) and RBPT (French). RBPT, (Pakistan) can be used for primary screening of
brucellosis cases because of cross reactivity present in RBPT antigen and confirmation must
be made with a more specific and sensitive serological test, such as B. abortus-specific
indirect modified ELISA. The results of present study showed that RBPT, Pakistan antigen
showed almost same sensitivity and specificity as that of RBPT (Pourquier, France) antigen.
Indirect modified ELISA is more specific as compared to RBPT (Pakistan) and RBPT
(French). It is highly suggestive to combine serodiagnostics test with molecular detection
including PCR and Real time PCR to increase the detection rate of brucellosis. Human
ELISA kit is extremely expensive that cannot be afforded in developing countries like
Pakistan to screen the human. PCR technique is highly reliable and less time consuming. It is
highly suggestive to conduct the study on human brucellosis on other districts of south
Punjab as it is believed that brucellosis is endemic due to lack of awareness and vaccination
in these areas.

Department of Epidemiology and Public Health


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