Test characteristics of the tuberculin skin test and post-mortem examination for bovine tuberculosis diagnosis in cattle in Northern Ireland estimated by Bayesian latent class analysis with adjustments for covariates.

M J H O'Hagan,H Ni,A Georgaki,F D Menzies,A V Pascual-Linaza,J A Stegeman

doi:10.1017/s0950268819000888

Abstract

The single intradermal comparative cervical tuberculin (SICCT) test and post-mortem examination are the main diagnostic tools for bovine tuberculosis (bTB) in cattle in the British Isles. Latent class modelling is often used to estimate the bTB test characteristics due to the absence of a gold standard. However, the reported sensitivity of especially the SICCT test has shown a lot of variation. We applied both the Hui-Walter latent class model under the Bayesian framework and the Bayesian model specified at the animal level, including various risk factors as predictors, to estimate the SICCT test and post-mortem test characteristics. Data were collected from all cattle slaughtered in abattoirs in Northern Ireland in 2015. Both models showed comparable posterior median estimation for the sensitivity of the SICCT test (88.61% and 90.56%, respectively) using standard interpretation and for post-mortem examination (53.65% and 53.79%, respectively). Both models showed almost identical posterior median estimates for the specificity (99.99% vs. 99.80% for SICCT test at standard interpretation and 99.66% vs. 99.86% for post-mortem examination). The animal-level model showed slightly narrower posterior 95% credible intervals. Notably, this study was carried out in slaughtered cattle which may not be representative for the general cattle population.

Highlights

Bovine tuberculosis is a chronic, infectious disease caused by Mycobacterium bovis that affects cattle and many other mammals including humans worldwide
Hui–Walter model The posterior medians and 95% CrI obtained for the test sensitivity and specificity of the single intradermal comparative cervical tuberculin (SICCT) test and post-mortem examination using non-informative priors are listed in Table 1 along with the estimated proportion of disease in the subpopulations
Estimation of test characteristics for diagnostic tests in the absence of a gold standard is notoriously difficult and this has been reflected by the increased use of Bayesian latent class analyses [16]

Summary

Introduction

Bovine tuberculosis (bTB) is a chronic, infectious disease caused by Mycobacterium bovis that affects cattle and many other mammals including humans worldwide. Infection with this bacterium often remains subclinical for a long period whilst cattle can be infectious. The single intradermal comparative cervical tuberculin (SICCT) test, based on the detection of a cell-mediated immune response, is the main ante-mortem diagnostic tool for bTB in cattle in the British Isles [2]. Animals can be classified as reactors to the SICCT test on standard, severe or super-severe interpretation based on the cut-off point used of the measured response to the injected bovine and avian tuberculins into the skin of the neck (the test is carried out as defined within the EU Council Directive 64/432/EEC, Annex B). Lowering the cut-off point will increase the sensitivity but in return decrease the specificity of the SICCT test and vice versa [3]

Methods

Results

Conclusion