Thousands of Kenyans wrongly diagnosed, treated for brucellosis

Thousands of Kenyans are being wrongly diagnosed and treated for the milk linked disease - brucellosis, reveals a new study.

Now researchers at the Kenya Medical Research Institute (Kemri) and six international institutions, want the responsible test withdrawn from public hospitals.

For example, in 2012 some 75,256 cases of brucellosis were reported to the Kenya Health Information System, but going by the new study only about one per cent of these patients may have been infected.

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“It is that bad. The diagnosis for brucellosis has been a challenge and it is time we looked into it seriously,” said study supervisor Prof Sam Kariuki of Kemri.

Prof Kariuki said such an off mark diagnostic tool has serious cost and health implications to patients.

“It is also a serious contributor to the growing antibiotic resistance in the country,” he said of the study led by John Mwaniki Njeru also of Kemri.

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The test

The test, called febrile antigen brucella agglutination test or FBAT is used in Government facilities throughout Kenya.

“It appears to have very poor diagnostic specificity and should be phased out,” the study recommends.

The study published on Friday in the journal PLOS Neglected Tropical Diseases also involved the Nairobi-based International Livestock Research Institute and several research institutions from Germany, UK, Spain and Sweden.

The researchers tested 825 patients for brucellosis at the Busia County Referral Hospital and at Kemri’s Alupe clinic in the same area.

The team used the regular government test FBAT, a second one called Rose Bengal Test (RBT), while another two kits were used to confirm the results.

Out of the 825 cases, 196 patients or 19.6 per cent were found positive for brucellosis from the regular tests.

However, when the positive cases were tested with the second and the other confirmatory tests only eight people or one per cent of the total were found to have been infected with brucellosis.

In this case, if not for the secondary and confirmatory tests 188 people would have unnecessarily been put on the rigorous brucellosis treatment.

This is something, the authors indicate may be happening across the country and especially among pastoralist communities who are normally in close contact with livestock.

Poor quality

The researchers also suspected the reagents being marketed to and used in government facilities to test for brucellosis are of poor quality and hinted at the possibility of foul play in their procurement.

They explain that while there are two strains of brucellosis which infect humans, there are no tests at clinic level which can distinguish between the two.

Yet Government health workers, the researchers said, claimed to be able to do so using varied reagents.

They recommend that all possible efforts be made to ensure reagents are sourced only from established sources with high standards of quality control.

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