title: Comparison of bovine tuberculosis recurrence in Irish herds between 1998 and 2008.
abstract: During the last several decades in Ireland, there has been substantial scientific progress in our understanding and related policy changes in the bovine tuberculosis (bTB) eradication programme. A range of performance measurements are routinely available, each highlighting a steadily improving situation in Ireland. However, recent research has highlighted an on-going problem of residual infection, contributing to recurrent breakdowns. In light of this general improvement, but also cognisant of residual infection, a critical evaluation of changes in effectiveness of managing recurrence is particularly valuable. Therefore, the objective of the study was to compare the herd-level risk of recurrence of bTB in Ireland between 1998 and 2008. A retrospective cohort study was carried out, using a Cox proportional-hazards model, to compare the risk of restriction recurrence in herds derestricted during 1998 and 2008. These herds were observed for up to 3 years from the end of the 'index restriction'. At the univariable level, 46.4% and 34.8% of study herds derestricted in 1998 and 2008, respectively, had a subsequent breakdown during the study period (χ(2)=70.6, P<0.001). In the multivariable analysis, there has been a significant reduction in bTB recurrence in Ireland, with 2008-derestricted herds being 0.74 times (95% confidence interval: 0.68-0.81) as likely to be restricted during the subsequent study period compared with 1998-derestricted herds. In the final Cox model, the rate of a future breakdown increased with increasing herd size, increasing number of standard reactors in the index restriction, increasing percentage of newly restricted herds within the District Electoral Division (DED) and if the herd had a previous bTB episode in the previous 5 years. The risk varied across herd type. The results from the current study provide further reassurance of an improved national situation, both in terms of limiting the establishment of new infection (bTB incidence) and in effectively clearing infection once detected (recurrence following derestriction). Recurrence of bTB requires effective implementation of multiple control strategies, focusing on identifying and removing residually infected cattle, and limiting environmental sources of infection, which in Ireland primarily relates to badgers.
authors.affiliation: Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland. martin.gallagher@ucd.ie
authors.forename: M J
authors.initials: MJ
authors.lastname: Gallagher
authors.forename: I M
authors.initials: IM
authors.lastname: Higgins
authors.forename: T A
authors.initials: TA
authors.lastname: Clegg
authors.forename: D H
authors.initials: DH
authors.lastname: Williams
authors.forename: S J
authors.initials: SJ
authors.lastname: More
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D002417:Cattle; D004196:Disease Outbreaks / Q000662:veterinary*; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012621:Seasons; D014380:Tuberculosis, Bovine / Q000453:epidemiology* / Q000382:microbiology
keywords: Bovine tuberculosis; Ireland; Recurrence; Restriction; Survival model