Evaluation of Diagnostic Sensitivity of Wright, Coombs Wright and 2-Mercapto Ethanol in Diagnosis of Brucellosis

Document Type : Original Quantitative and Qualitative Research Paper


1 Associate professor, Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Iran

2 Professor, Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Iran

3 Assistant professor, Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Iran


Background: Brucellosis is one of the important zoonotic diseases with variety of symptoms and signs. Using of cost effective, easy and safe diagnostic methods in screening of brucellosis is an important priority. Several studies have been carried out to recognize appropriate diagnostic methods and each have reported different results.
Aim: The aim of this study was to investigate the sensitivity of Wright, Coombs Wright and 2-Mercapto Ethanol tests in diagnosis of brucellosis.
Method: In these cross-sectional study 340 diagnosed inpatient cases of brucellosis from Hasheminegad Hospital, Mashhad was included in 2008. Demographic characteristics, clinical signs and laboratory results of subjects were collected.  Data analysis was done by SPSS11.5 and diagnostic sensitivity of Wright, Coombs Wright and 2-Mercapto Ethanol were assessed.
Results: Results showed that %54 of participants was male and %58 was in 20-40years old age group. The most common symptoms were fever (%34) and arthralgy (%22).Among patients there were 324 positive Coombs Wright test and 318 positive 2ME test. The sensitivity of Wright test was 92% (CI%95=83-95) and 80.6% (CI%95=76.6-85.1) according to the basis 1:80 and 1:160. Sensitivity of Coombs Wright and 2ME tests were 95.3% (CI%95=91.3-97.7) and 93.7% (CI%95=91.1-95.6), respectively.
Conclusion: To diagnose brucellosis Wright, Coombs Wright and 2ME tests, which are commonly used in Iran, are effective tests compared with other new and expensive diagnostic tests.


  1. Mantur B.G, Amarnath S.K. Brucellosis in India – a review; J. Biosci. 2008;33: 539–547.
  2. Refai  M. Incidence and control of brucellosis in the Near East region. Vet Microbiol. 2002; 90:81-110.
  3. Sirmatel F, tarker M, Bozkurt A. Evaluation of methods used for the serologic diagnostic of brucellosis , Microbiology bullotin.2002;36(2):161-167.
  4. Mantur B.G, Amarnath S.K, Shinde R.S.  Review of clinical and laboratory features of human brucellosis. Indian J. Med. Microbiol. 2007; 25: 188–202
  5. Aliskan H. The value of culture and serological methods in the diagnosis of human brucellosis. Microbiol Bull. 2008;42(1):185-95.
  6. Hajia M, Rahbar M, Hosseini Taghavi A. Brucellosis Antibody Level of Hospitalized Patients in Hamadan, Western Iran. Shiraz E-Medical Journal. 2007;8(3):127-131.
  7. Agasthya AS, Isloor S, Prabhudas K. Evaluation of brucella indirect enzyme linked immunosorbent assay in comparison with conventional serological tests in pyrexia of unknown origin cases. Asian J Microbiol Biotechnol Environ Sci. 2009;11(3):671-675.
  8. Memish Z.A, Almuneef M, Mah M.W, Qassem L.A, Osoba A.O. Comparison of the Brucella Standard Agglutination Test with the ELISA IgG and IgM in patients with Brucella bacteremia. Diagn Microbiol Infect Dis 2002; 44(2): 129-132.
  9. Raptis L. Pappas G. Akritidis N. A cutaneous cyst caused by brucellosis with a negative serological test. Int. J. Infect. Dis. 2007;11(1):82-3.
  10. Gotuzzo  E, Carillo C, Guerra J, Llosa L. An evaluation of diagnostic methods for brucellosis-the value of bone marrow culture. J Infect Dis.1986; 153:122–125.
  11. Mert A, Ozaras R, Tabak F. The sensitivity and specificity of Brucella agglutination test. Diagnostic Microbiology and infectious disease. 2003; 46(4):241-243.
  12. Momen Heravi M, Afzali H. Clinical manifestations of brucellosis in hospitalized patients in Beheshti Hospital of Kashan1996-2003. Feyz J. 2007; 11(1): 67-72
  13. Mohraz M, Kariminia A, Sarafnejad AF. The Evaluation of Serologic Test (Elisa) in Brucellosis identification at Imam Khomaini Hospital. Infectious and Tropical disease. 2003; 8(23):10-3.
  14. Vakili Z, Momen Heravi M, Sharif A, Masoomi M. Sensitivity and specificity of ELISA test in diagnosis of brucellosis. Kowsar Medical J. 2010:15; 95-98.
  15. Ghilian R, Hekmati Moghaddam S.H , Fatemi A, Eslamieh H, Dargahi M. Seroepidemiologic status of brucellosis in blood donors
    in Yazd, 2009. Sci J Iranian Blood Transfus Org. 2011; 7(4):196-205.
  16. Sirmatel F, Turker M, Bozkurt A.I. Evaluation of the methods used for the serologic diagnosis of brucellosis. Mikrobiyol Bul. 2002; 36(2): 161-167.
  17. PeeriDogaheh H,Arzanlou M, Hosseini S, Habibi N.Determination of sensitivity and specificity of PCR in diagnosis of human brucellosis. Arak Medical University J. 2012; 15(64): 10-17.