title: Evaluation of the sensitivity and specificity of bovine tuberculosis diagnostic tests in naturally infected cattle herds using a Bayesian approach.
abstract: Test-and-slaughter strategies have been the basis of bovine tuberculosis (BT) eradication programs worldwide; however, eradication efforts have not succeeded in certain regions, and imperfect sensitivity and specificity of applied diagnostic techniques have been deemed as one of the possible causes for such failure. Evaluation of tuberculosis diagnostic tools has been impaired by the lack of an adequate gold standard to define positive and negative individuals. Here, a Bayesian approach was formulated to estimate for the first time sensitivity (Se) and specificity (Sp) of the tests [single intradermal tuberculin (SIT) test, and interferon-gamma (IFN-γ) assay] currently used in Spain. Field data from the first implementation of IFN-γ assay (used in parallel with SIT test 2-6months after a first disclosure SIT test) in infected beef, dairy and bullfighting cattle herds from the region of Castilla and Leon were used for the analysis. Model results suggested that in the described situation: (i) Se of SIT test was highly variable (40.1-92.2% for severe interpretation, median=66-69%), and its Sp was high (>99%) regardless interpretation criteria; (ii) IFN-γ assay showed a high Se (median=89-90% and 83.5% for 0.05 and 0.1 cut-off points respectively) and an acceptable Sp (85.7% and 90.3% for 0.05 and 0.1 thresholds) and (iii) parallel application of both tests maximized the combined Se (95.6% using severe SIT and 0.05 cut-off point in the IFN-γ assay). These results support the potential use of the IFN-γ assay as an ancillary technique for routine BT diagnosis.
authors: Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s/n, 13071 Ciudad Real, Spain.
authors: Julio
authors: J
authors: Alvarez
authors: Andrés
authors: A
authors: Perez
authors: Javier
authors: J
authors: Bezos
authors: Sergio
authors: S
authors: Marqués
authors: Anna
authors: A
authors: Grau
authors: Jose Luis
authors: JL
authors: Saez
authors: Olga
authors: O
authors: Mínguez
authors: Lucía
authors: L
authors: de Juan
authors: Lucas
authors: L
authors: Domínguez
mesh_terms: D000818:Animals; D001499:Bayes Theorem; D002417:Cattle; D012680:Sensitivity and Specificity; D013030:Spain; D014374:Tuberculin Test / Q000592:standards / Q000662:veterinary*; D014380:Tuberculosis, Bovine / Q000175:diagnosis* / Q000276:immunology