| Objective:1.To understand the epidemic characteristics of brucellosis in Hulunbeier area and to provide reference for the formulation of prevention and control measures through the retrospective analysis of the information of patients with brucellosis in HULUNBEIER PEOPLE'S HOSPITAL from 2018 to 20192.To provide information for the selection of serological detection methods of brucellosis in primary hospitals in the future through analyzing the positive detection rate,detection consistency and diagnostic performance of Rose-Bengal Plate Agglutination Test(RBPT),Serum Tube Agglutination Test(SAT)and Cysteine Test in Brucella serological detection and exploring the advantages and disadvantages of the three serological tests and their application value in the diagnosis of brucellosis.Method:1.Epidemiological characteristics of brucellosis in Hulunbeier areaHULUNBEIER PEOPLE'S HOSPITAL is the regional health and medical center of Hulunbeier area,and Brucellosis Department is a national key clinical specialty,Gender,age,nationality,time of illness,region and occupation of 776 patients confirmed with brucellosis from January 1,2018 to December 3 1,2019 in the hospital were collected.Through adopting descriptive epidemiological investigation methods,data reduction by Microsoft Excel 2010,and chi-square test(?2 tests)by SPSS 19.0 software,epidemic characteristics of brucellosis were analyzed.2.Comparison and analysis of RBPT,SAT and Cysteine Test for the diagnosis of brucellosis.2202 serological test samples of Brucella through the first inspection from January 1,2018 to December 31,2019 were collected from HULUNBEIER PEOPLE'S HOSPITAL.Three serological methods RBPT,SAT and Cysteine Test were conducted.Excel was used to sort out the data,SPSS 19.0 software was used to carry out ?2 test,McNemar test and Kappa test.Receiver Operating Characteristic(ROC)curves of the subjects was analyzed.The positive detection rate,detection consistency and diagnostic performance of the three serological methods were comparedResults:1.Epidemiological characteristics of brucellosis in Hulunbeier area.Through statistical analysis of the relevant information on cases confirmed with brucellosis in HULUNBEIER PEOPLE'S HOSPITAL from 2018 to 2019,it can be seen that the epidemic characteristics of brucellosis in Hulunbeier area are as follows1.1 Overall Detection of Brucellosis Patients from 2018 to 2019The positive detection rate from 2018 to 2019 is 35.24%,of which the positive detection rate in 2018 is 33.72%and the positive detection rate in 2019 is 36.84%.There was no statistically significant difference between 2018 and 2019(?2=1.123,P=0.289>0.05).1.2 Gender characteristicsIn 2018 and 2019,the sex ratio of male patients was higher than that of female patients.In the two years,male patients account for 69.59%,female patients account for 30.41%,and the sex ratio is 2.29:1.The gender difference of patients was statistically significant(?2=43.505,P<0.001).1.3 Age characteristicsThe age distribution trend in 2019 was the same as that in 2018,with the highest age of 41-50 years old,accounting for more than 30%.In the past two years,the patient's age was as young as 1 year old and as old as 81 years old,with an average age of 43.73 years old.There was no significant difference in the distribution of patients among different age ranges(x2=9.351,P=0.228>0.05).The majority of patients were 41-50 years old(33.25%),followed by 51-60 years old(22.42%)and 31-40 years old(22.42%).The number of patients between 31-60 years old accounted for 78.09%of the total number of confirmed patients.1.4 National characteristicThe ethnic distribution trend in 2018 equaled to that in 2019,and the patients are mainly Han and Mongolian.Han nationality accounted for 66.88%of the total number of patients in the two years,Minorities accounted for 33.12%,of which Mongolian accounted for 23.71%and other Minorities accounted for 9.41%,which was basically consistent with the nationality distribution base in Hulunbeier area.1.5 Time characteristicsFrom 2018 to 2019,the top three months of brucellosis patients in Hulunbeier region were December(90 cases,11.60%),June(85 cases,10.95%)and November(76 cases,9.79%).The top three months of brucellosis patients in 2018 were similar to those of the two years,(December/52 cases,accounting for 13.68%of patients in 2018;June/49 cases,12.89%;November/40 cases,11.53%).While the top three in 2019 were different from the above,which are April(48 cases,accounting for 12.12%of patients in 2019),July(40 cases,10.10%)and December(38 cases,9.60%).There was a statistically significant difference in the month distribution of brucellosis patients between 2018 and 2019(?2=20.518,P=0.039<0.05);However,excluding the cluster of patients in April 2019,the number of cases in April was basically the same in two years.1.6 Regional characteristicsThe regional distribution trend in 2018 was basically equal to that in 2019.Among 776 confirmed patients,394(accounting for 50.77%)were from urban and agricultural areas in Hulunbeier region.The four Banners of animal husbandry in traditional pastoral areas(Ewenki Autonomous Banner,Xin Barag Left Banner,Xin Barag Right Banner and Prairie Chenbarhu banner)totaled 268(accounting for 34.54%).The top three cases of brucellosis in counties and districts are Hailar District(112 cases,accounting for 14.43%),Prairie Chenbarhu banner(98 cases,accounting for 12.62%)and Erguna City(84 cases,accounting for 10.82%).1.7 Occupational characteristicsAmong 776 confirmed cases,there was no statistically significant difference in the occupational distribution of patients between 2018 and 2019(?2=12.259,P=0.140>0.05).The top three were 381 cases(49.10%)of farmers and herdsmen,199 cases(25.64%)of herdsmen and 64 cases(8.25%)of slaughterers.Occupational characteristics were mainly distributed in occupations related to animal husbandry.2.Comparison and Analysis of Three Serological Detection Methods for Brucella2.1 Comparison of positive detectable rates of RBPT,SAT and Cysteine TestThe positive detection rates of RBPT,SAT and Cysteine Test for Brucella were 39.69%,35.24%and 34.79%respectively.Results showed that there was significantly statistical difference between RBPT and SAT(?2=9.38,P=0.002<0.01),as well as between RBPT and Cysteine Test(?2=11.332,P=0.001<0.01).While there was no significantly statistical difference between Cysteine Test and SAT(?2=0.100,P 0.752>0.05).2.2 Consistency comparison of SAT,RBPT and Cysteine Test2.2.1 Statistical analysis of SAT and RBPTMcNemar test showed that the positive(or negative)rates of SAT and RBPT were of significantly statistical difference(P<0.001).The Kappa test was used to analyze the consistency(Kappa? 0.75,the consistency was good;0.75>Kappa? 0.4,the consistency was general;Kappa<0.4,the consistency was poor).The results showed that the Kappa value of the two serological tests was 0.886,indicating that the consistency was good.2.2.2 Statistical analysis of SAT and Cysteine TestMcNemar test showed that there was no significantly statistical difference in positive(or negative)detection rate between SAT and Cysteine Test(P=0.358>0.05).The Kappa value of the two methods was 0.904,which showed that the two methods were in good consistency.2.2.3 Statistical Analysis of RBPT and Cysteine TestMcNemar test showed that the positive(or negative)rates of RBPT and Cysteine Test were significantly different(P<0.001).The Kappa value of the two methods was 0.88,which showed that the two methods were in good consistency.2.3 Evaluation of Diagnostic Performance of RBPT,Cysteine Test and SATROC curve was made using SAT as the gold standard serological test for Brucella.The Area Under Curve(AUC)was between 0 and 1.The larger the AUC,the better the diagnostic performance for the disease.The AUC of RBPT and Cysteine Test were 0.956 and 0.95 1 respectively,which showed that the two methods had good diagnostic performance for brucellosisConclusion:1.The main epidemiological characteristics of brucellosis in Hulunbeier area were more males than females,the onset age was mainly concentrated in 31-60 years old.There were more onsets in June-July and November-December,and the number of patients in urban and agricultural areas was larger,followed by the four Banners of traditional animal husbandry,the high incidence of brucellosis was mainly related to animal husbandry,and the onsets of brucellosis were more in farmers,herdsmen and herdsmen.In the future,we should increase the publicity of health educational propaganda and prevention strategies in cities and agricultural areas;healthy education and disease screening for middle-aged men in epidemic areas should be strengthened.Large-scale disease prevention and control publicity should be carried out on the eve of the epidemic season as far as possible to remind the majority of high-risk groups to take good protection during the operation2.Among the three serological detection methods,RBPT was the simplest,took the shortest time,with the highest positive detection rate and good consistency with the diagnosis test,which was suitable for large-scale screening of brucellosis.The consistency between Cysteine Test and SAT was high,with ideal diagnostic performance.The synergistic detection of the three serological methods can provide laboratory diagnostic basis for brucellosis screening,diagnosis,differential diagnosis and curative effect observation.Primary hospitals can select corresponding methods or combinations according to the actual conditions. |
PDF Full Text Request