新疆牧区 1 342 例布鲁氏菌病血清学筛查效果评价

Abstract: Objective To assess and compare the diagnostic performance of five serological methods—rose bengal plate test (RBPT), serum agglutination test (SAT), enzyme-linked immunosorbent assay (ELISA), gold immunochromatography assay (GICA), and microcolumn gel assay—for human brucellosis, which providing a basis for optimizing detection strategies. Methods In the pastoral area of Wensu County, Xinjiang, 1342 serum samples from high-risk groups were collected and five methods were used for parallel detection. Through comparative analysis of the results of the five detection methods, the sensitivity, specificity, total concordance rate and Kappa value of different detection methods were verified. Results GICA exhibited the highest sensitivity (94.21%), but its number of positive detections (210 cases) exceeds the true positive count determined by the composite standard (190 cases), indicating the presence of false positive results (specificity 97.31%). Microcolumn gel assay achieved 81.58% sensitivity and 94.78% total concordance (Kappa=0.7854). RBPT demonstrated moderate sensitivity (65.26%) and high specificity (98.00%, Kappa=0.6987). SAT and ELISA exhibited critically low sensitivity (31.05% and 27.89%), indicating high underdiagnosis risk. Conclusion GICA has the highest accuracy. In the process of serological identification of brucellosis, corresponding identification techniques should be selected according to the identification requirements. GICA is the first choice as the detection method. If necessary, the detection method can be combined with microcolumn gel method and RBPT.