Serological diagnosis of bovine brucellosis: a review of test performance and cost comparison.

The authors reviewed over 50 publications in which the sensitivity and specificity values of assays used for the detection of exposure to Brucella abortus had been examined. The sum of the sensitivity and specificity values for each test was averaged to give a performance index (PI) and allow for a comparison between the different methodologies. A score of 200 was perfect. Based on the PI, the buffered antigen plate agglutination test (BPAT) rated highest (PI = 193.1) among the conventional tests. This indicates better accuracy than the other conventional tests including the Rose Bengal test (PI = 167.6) and the complement fixation test (PI = 172.5). Overall, the primary binding assays, including the fluorescence polarisation assay (PI = 196.4), the indirect enzyme-linked immunosorbent assay (PI = 189.8) and the competitive enzyme-linked immunosorbent assay (PI = 188.2), were more accurate than the conventional tests, except for the BPAT. In addition, a fee comparison suggested that the primary binding tests were price competitive with conventional tests for the diagnosis of brucellosis and, therefore, had a better combined cost/efficiency rating.