Bayesian estimation of true prevalence, sensitivity and specificity of indirect ELISA, Rose Bengal Test and Slow Agglutination Test for the diagnosis of brucellosis in sheep and goats in Bangladesh

Bayesian true prevalence estimation of brucellosis in sheep, goats, cattle and camels in southeast regions of Iran

AIMS AND METHODS

Brucellosis is worldwide one of the most prevalent zoonotic diseases with serious public health hazard affecting domestic livestock and causing economic losses. Objective of this study is to estimate the true prevalence of brucellosis in livestock, specifically cattle, sheep, goats and camels, using a novel Bayesian latent class model, adjusting for the imperfect sensitivity and specificity of the applied tests, where the second test was restricted only to first test-positive samples.

RESULTS

Brucellosis seems more prevalent in goats and sheep, while the posterior medians and 95% probability intervals (95% PI) for the average true prevalence for sheep, goats, cattle and camels are 18% (4%-43%), 19% (7%-37%), 16% (5%-34%) and 18% (1%-48%) respectively.

CONCLUSIONS

The study results indicate that brucellosis is highly endemic in Iran and crucial steps are needed to control and raise awareness about the high public health concern of the disease.

Herd and animal level seroprevalence and associated risk factors of small ruminant brucellosis in the Korahey zone, Somali regional state, eastern Ethiopia

Introduction

Brucellosis is a zoonosis of major public health and economic importance that is endemic in livestock in Ethiopia with varying levels of seroprevalence.

Methods

A cross-sectional study was carried out to determine the individual and herd-level seroprevalence of brucellosis in small ruminants in the Korahey zone of the Ethiopian Somali Region. A total of 324 sera from 63 herds of small ruminants were collected randomly using a multistage sampling technique and the sera were tested using the Rose Bengal Plate Test, and seropositive reactors were confirmed by the Complement Fixation Test.

Results and discussion

The seroprevalence of brucellosis at the herds and the individual level was 6.35% (95% CI: 0.0-13%) and 1.23% (95% CI: 0.0-2%), respectively; with 1.4% in goats and 0.9% in sheep. Moreover, predicted variables like age group, parity, history of abortion, fetal membranes, herd size, ownership of other livestock species, contact with wild animals in the past year, the introduction of new animals in the past year, and lending of breeding males in the past year were not significantly associated (p > 0.05) with Brucella seropositivity at individual and herd level seroprevalence during multivariable logistic regression analysis. Pastoral community awareness regarding the public health impact of brucellosis and the promotion of an intersectoral One Health approach for the effective control of brucellosis is recommended.

Rapid discrimination of Brucellosis in sheep using serum Fourier transform infrared spectroscopy combined with PCA-LDA algorithm

Brucellosis in sheep is an infectious disease caused by Brucella melitensis in sheep. The current conventional serological methods for screening Brucella-infected sheep have the disadvantage of time consuming and low accuracy, so a simple, rapid and highly accurate screening method is needed. The aim of this study was to evaluate the feasibility of diagnosing Brucella-infected sheep by serum samples based on the Fourier transform infrared (FTIR) spectroscopy. In this study, FTIR spectroscopy of serum from Brucella-infected sheep (n=102) and healthy sheep (n=125) revealed abnormal protein and lipid metabolism in serum from Brucella-infected sheep compared to healthy sheep. Principal component analysis-Linear discriminant analysis (PCA-LDA) method was used to differentiate the FTIR spectra of serum from Brucella-infected sheep and healthy sheep in the protein band (3700-3090 cm^-1) and lipid band (3000-2800 cm^-1), and its overall diagnostic accuracy was 100% (sensitivity 100%, specificity 100%). In conclusion, our results suggest that serum FTIR spectroscopy combined with PCA-LDA algorithm has great potential for brucellosis in sheep screening.

Sero-prevalence and risk factors associated with brucellosis in dairy cattle of Sylhet District, Bangladesh: A cross-sectional study

BACKGROUND

Brucellosis is an emerging disease that causes a significant impact on productive and reproductive performance in dairy cattle. Though Brucella is a pivotal microorganism for dairy cattle, the scenario of brucellosis in Sylhet District is unknown.

OBJECTIVES

A cross-sectional study was carried out to assess the prevalence and determinants associated with brucellosis in dairy cattle of Sylhet District.

METHODS

A total of 386 sera and data on determinants from 63 dairy herds were collected from 12 sub-districts using simple random sampling. The sera were tested with Rose Bengal Brucella antigen test, Brucella abortus plate agglutination test and serum agglutination test to find out the sero-positivity.

RESULTS

Overall, 17.09% (95% CI: 13.67-21.18) prevalence in cows were calculated. Relatively higher prevalence (56.08%; 95% CI: 42.23-70.32) was recorded in cows having parity ≥4 and were at higher risk (OR = 7.28) than the other cows with parity 0-3. Prevalence was significantly higher in cows with history of abortion 90.63% (95% CI: 75.79-96.76), repeat breeding 79.17% (95% CI: 65.74-88.27) and reproductive abnormalities 48.54% (95% CI: 39.12-58.07). Farm-level prevalence was high in farms with the previous history of abortion 95.45% (95% CI: 78.20-99.19) and repeat breeding 90.00% (95% CI: 74.38-96.54).

CONCLUSIONS

The prevalence was high in Sylhet district, which might be a public health concern. Therefore, this study would represent the baseline information for guiding brucellosis control and prevention.

Performance of Loop-Mediated Isothermal Amplification Technique in Milk Samples for the Diagnosis of Bovine Tuberculosis in Dairy Cattle Using a Bayesian Approach

This study aimed to estimate the sensitivity (Se) and specificity (Sp) of loop-mediated isothermal amplification (LAMP) and single intradermal tuberculin (SIT) tests for the diagnosis of bovine tuberculosis (bTB) in dairy cattle in Thailand using a Bayesian approach. The SIT test was performed in 203 lactating dairy cattle from nine dairy farms located in Chiang Mai province, Thailand. Milk samples were collected for the LAMP test. Kappa analysis was performed to determine the agreement between the two tests. A one-population conditional independence Bayesian model was applied to estimate the Se and Sp of the two tests. Of 203 dairy cattle, 2 were positive for the SIT test using standard interpretation, whereas 38 were positive for the LAMP test. A poor agreement (kappa = 0) was observed between the two tests. The median Se and Sp of the SIT test using standard interpretation were 63.5% and 99.1%, respectively. The median Se and Sp of the LAMP test were 67.2% and 82.0%, respectively. The estimated true prevalence of bTB was 3.7%. The LAMP test with milk samples can potentially be used as a non-invasive screening test for the diagnosis of bTB in dairy cattle.

Evaluation of diagnostic tests' sensitivity, specificity and predictive values in bovine carcasses showing brucellosis suggestive lesions, condemned by Brazilian Federal Meat Inspection Service in the Amazon Region of Brazil

Cervical bursitis is a suggestive lesion of bovine brucellosis. Diagnostic sensitivity and specificity of two brucellosis serological tests, Rose Bengal (RB) and serum agglutination test with 2-mercaptoethanol (SAT/2-ME), and of isolation and identification (bacteriology) were evaluated through Bayesian latent class analysis (BLCA). A total of 165 paired serum and cervical bursitis samples detected at inspection by Brazilian federal meat inspection services were analyzed. The best model fit to the data occurred when accounting for the conditional dependence between serological tests. According to this model, RB and SAT/2-ME had almost the same sensitivity, 0.960 [0.903 - 0.992] and 0.963 [0.906 - 0.994] with 95 % Credible Interval (95 %CrI), respectively. Specificities were 0.9068 [0.562 - 0.997] and 0.875 [0.546 - 0.990] for RB and SAT/2-ME, respectively, also with 95 %CrI. Bacteriology had lower sensitivity than serological tests, 0.594 (95 %CrI: [0.525 - 0.794]) and the highest specificity of all evaluated tests, 0.992 (95 %CrI: [0.961-1.00]). Prevalence of infected animals was 0.829 (95 %CrI: [0.700-0.900]). BLCA showed that both RB and SAT/2-ME fitted to the purpose of initial screening the brucellosis suspect in carcasses with cervical bursitis in a reliable way. The results of RB or SAT/2-ME can guide the sanitary actions for brucellosis control and help the implementation of a risk-based surveillance system in the meat production chain. This strategy is especially true in remote areas with large beef cattle herds, raised extensively, where in vivo tests are rarely performed due to logistic and management constraints, as in the Northern region of Brazil.

Bayesian Estimation of the Prevalence and Test Characteristics (Sensitivity and Specificity) of Two Serological Tests (RB and SAT-EDTA) for the Diagnosis of Bovine Brucellosis in Small and Medium Cattle Holders in Ecuador

In Ecuador, a national program for bovine brucellosis control has been in implementation since 2008. Given the costs, small- and medium-sized livestock holders are not completely committed to it. The objective of this study was to determine true prevalence (TP) of bovine brucellosis in small- and medium-sized herd populations, as well as the diagnostic sensitivity and specificity of the Rose Bengal (RB) test and the sero-agglutination test (SAT)-EDTA using a Bayesian approach. Between 2011 and 2016, 2733 cattle herds were visited, and 22,592 animal blood samples were taken in nineteen provinces on mainland Ecuador. Bayes-p and deviance information criterion (DIC) statistics were used to select models. Additionally, risk-factor analysis was used for herds according to their brucellosis test status. True prevalence (TP) in herds was estimated by pool testing. National seroprevalence of farms was 7.9% (95% CI: 6.79–9.03), and TP was 12.2% (95% CI: 7.8–17.9). Apparent prevalence (AP) in animals was 2.2% (95% CI: 1.82–2.67), and TP was 1.6% (95% CrI: 1.0–2.4). Similarly, the sensitivity of the RB was estimated at 64.6% (95% CrI: 42.6–85.3) and specificity at 98.9% (95% CrI: 98.6–99.0); for the SAT-EDTA test, sensitivity was 62.3% (95% CrI: 40.0–84.8) and 98.9% (95% CrI: 98.6–99.1) for specificity. Results of the two tests were highly correlated in infected and uninfected animals. Likewise, high spatial variation was observed, with the Coastal Region being the zone with the highest TP at 2.5%. (95% CrI: 1.3–3.8%) in individual animals and 28.2% (95% CI: 15.7–39.8) in herds. Risk factors include herd size, type of production (milk, beef, and mixed), abortions recorded, and vaccination. The results of this study serve to guide authorities to make decisions based on parallel testing at the beginning of a bovine brucellosis program for small livestock holders to increase sensitivity level of the screening tests in Ecuador.

Prevalence, distribution and risk factors for brucellosis infection in goat farms in Ningxiang, China

Background

In south China, goats are the major source of Brucellosis for human infection. However, there are few studies on the prevalence of and risk factors for goat brucellosis in south China. In this study, we conducted a cross-sectional study to investigate the herd prevalence, spatial distribution and relevant risk factors for goat brucellosis in Ningxiang county, south China. Commercial goat farms (n = 457) were randomly selected, and their disease status was ascertained by testing serum samples of chosen individuals using the Rose Bengal Test (screening test) and the Serum Agglutination Test (confirmatory test) in series. A farm with at least two positive individuals was defined as a case farm. Standardized questionnaires were used to collect information on management and hygiene practices in farms. A logistic model with a binomial outcome was built to identify risk factors for being seropositive.

Results

The true herd prevalence in commercial goat farms was 4.5% (95%CI: 0.2%-12.2%) and the townships in the centre of the county had higher herd prevalence. The risk factors associated with seropositive on local goat farms include “Introduction in the past 12 months” (OR= 61, 95%CI: 16-333), “Improperly disposal of the sick or dead goats” (OR= 33, 95%CI: 5-341) and “Poor hygiene in lambing pen” (OR= 25, 95%CI: 5-192).

Conclusions

These findings will aid in the development of control strategies of Brucellosis in south China and risk factors identified in this study should be taken into consideration when designing a control strategy.

Assessment of Seroprevalence and the Risk Factors of Sheep Brucellosis in Basrah (Southern Iraq): A Challenge to Prospectively Control Brucellosis

Brucellosis is one of the most important foodborne infectious diseases distributed widely in low- and middle-income countries. The current study was carried out to investigate the prevalence and risk factors that influence the distribution of Brucella in sheep. A structured questionnaire was prepared and introduced to a total of 60 resident owners from five counties, and 400 sheep blood samples were randomly collected from the selected herds. The sera of isolated sheep were tested for Brucella spp. using the Rose Bengal Test (RBT). A univariable and multivariable logistic regression analysis was used to evaluate the risk factors linked to animal management and husbandry practices at the farm level. The overall prevalence estimated for brucellosis was 31% (95% confidence interval [Cl]: 26.5–35.8). The odds of seroprevalence in sheep >1 year were significantly higher than those in sheep ≤1 year (odds ratio [OR]: 2.2, 95% Cl: 1.41–3.44). The logistic regression outcomes revealed that two variables related to the management and practices at the farm level were significantly associated with the seroprevalence of brucellosis. These variables were sheep sheep grazing with other flocks (OR: 5.8, 95 Cl% Cl: 1.53–22.67) and the practice of lending ram among sheep owners (OR: 9.3, 95% Cl: 1.05–83.82). Unconfined domesticated dogs, improper handling of aborted ewes, introduction of new animals in a herd, (purchased), and lack of knowledge about brucellosis among owners were underlined to be further important factors that could influence the spread of brucellosis. This study concluded that brucellosis is an endemic disease in Basrah, and the animal vaccination control program with an integrated health education program for sheep owners are obligatory elements of the prevention measures needed to be established to minimize the risk of brucellosis in Basrah.

Evaluation of an in-house indirect enzyme-linked immunosorbent assay of feline panleukopenia VP2 subunit antigen in comparison to hemagglutination inhibition assay to monitor tiger antibody levels by Bayesian approach

Background

Feline panleukopenia virus (FPV) is an etiologic pathogen of feline panleukopenia that infects all members of Felidae including tigers (Panthera tigris). Vaccinations against FPV among wild felid species have long been practiced in zoos worldwide. However, few studies have assessed the tiger immune response post-vaccination due to the absence of a serological diagnostic tool. To address these limitations, this study aimed to develop an in-house indirect enzyme-linked immunosorbent assay (ELISA) for the monitoring of tiger antibody levels against the feline panleukopenia vaccine by employing the synthesized subunit capsid protein VP2. An in-house horseradish peroxidase (HRP) conjugated rabbit anti-tiger immunoglobulin G (IgG) polyclonal antibody (HRP-anti-tiger IgG) was produced in this study and employed in the assay. It was then compared to a commercial HRP-conjugated goat anti-cat IgG (HRP-anti-cat IgG). Sensitivity and specificity were evaluated using the Bayesian model with preferential conditional dependence between HRP-conjugated antibody-based ELISAs and hemagglutination-inhibition (HI) tests.

Results

The posterior estimates for sensitivity and specificity of two indirect ELISA HRP-conjugated antibodies were higher than those of the HI test. The sensitivity and specificity of the indirect ELISA for HRP-anti-tiger IgG and HRP-anti-cat IgG were 86.5, 57.2 and 86.7%, 64.6%, respectively, while the results of the HI test were 79.1 and 54.1%. In applications, 89.6% (198/221) and 89.1% (197/221) of the tiger serum samples were determined to be seropositive by indirect ELISA testing against HRP-anti-tiger and HRP-anti-cat, respectively.

Conclusion

To the best of our knowledge, the specific serology assays for the detection of the tiger IgG antibody have not yet been established. The HRP-anti-tiger IgG has been produced for the purpose of developing the specific immunoassays for tigers. Remarkably, an in-house indirect ELISA based on VP2 subunit antigen has been successfully developed in this study, providing a potentially valuable serological tool for the effective detection of tiger antibodies.

Detection of Brucella antibodies in domestic animals of southern Cameroon: Implications for the control of brucellosis

Brucellosis is one of the world's most widespread bacterial zoonoses caused by Brucella. It leads to considerable economic losses as a result of low productivity of infected animals and the long debilitating illness in humans. Despite its impact on human and animal health, little attention has been paid on Brucella infections in domestic animals. It is in this light that the prevalence of Brucella antibodies was determined in domestic animals with the overarching goal of improving our knowledge on brucellosis in southern Cameroon. During cross-sectional studies conducted from December 2016 to August 2018 in five sites of southern Cameroon, blood samples were collected in cattle, sheep, goat, pig and dog. Plasma was obtained from each blood sample and Brucella antibodies were detected using the Rose Bengal test and the enzyme-linked immunosorbent assay (ELISA). From 1873 animals that were sampled, the overall prevalence of Brucella antibodies using Indirect enzyme-linked immunosorbent assay (i-ELISA) was 6.35% (118/1873): 9.12% (78/855) in cattle; 8.04% (30/373) in sheep; 6.06% (2/33) in dog, 1.87% (3/160) in pig and 1.1% (5/452) in goat. Between animal species (p-value < .0001, x2  = 33.63) as well as sampling sites (p-value = .0001, x2  = 18.97), significant differences were observed in the prevalence of Brucella antibodies. Yoko and Noun localities have shown the highest prevalence of 8.6% (30/348) and 7.2% (78/1070), respectively. This prevalence was significantly higher (p = .03, x2  = 1.25) in female than male cattle. Between adult (16.923%) and young cattle (7.8%), significant difference (p = .04, x2  = 6.42) was observed in the prevalence of Brucella antibodies. This study shows that the prevalence of Brucella antibodies varies between animal species and localities. It also shows several domestic animals of southern Cameroon that have been in contact with Brucella. It enabled to identify villages where investigations on the transmission dynamic must be focused for the final goal of developing control measures for this neglected zoonotic disease.

Diagnostic test evaluation methodology: A systematic review of methods employed to evaluate diagnostic tests in the absence of gold standard - An update

OBJECTIVE

To systematically review methods developed and employed to evaluate the diagnostic accuracy of medical test when there is a missing or no gold standard.

STUDY DESIGN AND SETTINGS

Articles that proposed or applied any methods to evaluate the diagnostic accuracy of medical test(s) in the absence of gold standard were reviewed. The protocol for this review was registered in PROSPERO (CRD42018089349).

RESULTS

Identified methods were classified into four main groups: methods employed when there is a missing gold standard; correction methods (which make adjustment for an imperfect reference standard with known diagnostic accuracy measures); methods employed to evaluate a medical test using multiple imperfect reference standards; and other methods, like agreement studies, and a mixed group of alternative study designs. Fifty-one statistical methods were identified from the review that were developed to evaluate medical test(s) when the true disease status of some participants is unverified with the gold standard. Seven correction methods were identified and four methods were identified to evaluate medical test(s) using multiple imperfect reference standards. Flow-diagrams were developed to guide the selection of appropriate methods.

CONCLUSION

Various methods have been proposed to evaluate medical test(s) in the absence of a gold standard for some or all participants in a diagnostic accuracy study. These methods depend on the availability of the gold standard, its' application to the participants in the study and the availability of alternative reference standard(s). The clinical application of some of these methods, especially methods developed when there is missing gold standard is however limited. This may be due to the complexity of these methods and/or a disconnection between the fields of expertise of those who develop (e.g. mathematicians) and those who employ the methods (e.g. clinical researchers). This review aims to help close this gap with our classification and guidance tools.

Determination of the sensitivity and specificity of bovine tuberculosis screening tests in dairy herds in Thailand using a Bayesian approach

Background

The objective of this study was to determine the sensitivity (Se) and specificity (Sp) of bovine tuberculosis (bTB) screening tests including a single intradermal tuberculin (SIT) test, interferon gamma (IFN-γ) assay, and a commercial ELISA test (M. bovis Ab) in dairy cattle, under field conditions, using a Bayesian approach.

Results

The study population consisted of 128 dairy cows from 25 bTB-infected herds in Chiang Mai and Chiang Rai provinces, Thailand. A single-population Bayesian model was implemented assuming conditional dependence between the SIT test and IFN-γ assays. The 95% posterior probability interval (PPI) of the SIT test (severe interpretation) Se ranged from 75.3 to 95.2% (median = 87.6%), while the Sp was slightly lower (median = 83.6%, PPI = 74.2–92.8%). The IFN-γ assay Se was moderate and the 95% PPI ranged from 38.6 to 74.4% (median = 55.7%) with higher Sp (median = 93.5.4%, PPI = 87.0–98.1%). The M. bovis Ab ELISA Se was low, with 95% PPI ranging between 30.0 and 71.2% (median = 47.4%); however, the Sp was high (median = 90.9%, PPI = 84.5–95.5%).

Conclusion

The SIT test sensitivity was similar to that demonstrated in other regions and can, therefore, be used effectively as part of control programs in this area. The IFN-γ and M. bovis Ab ELISA assays can be applied as supplementary techniques. The test performance of these tests when used as single tests without confirmation, however, are expected to continue to challenge disease eradication efforts.

Electronic supplementary material

The online version of this article (10.1186/s12917-019-1905-x) contains supplementary material, which is available to authorized users.

Evaluation of post-mortem diagnostic tests' sensitivity and specificity for bovine tuberculosis using Bayesian latent class analysis

This study aimed to evaluate the performance of real-time PCR (qPCR), ELISA IDEXX™, and bacterial isolation as post-mortem diagnostic tests in animals with lesions compatible with bovine tuberculosis detected by Brazilian Federal Inspection Service as part of the bovine tuberculosis active surveillance. Bayesian latent class models were used to estimate diagnostic tests' sensitivity, specificity, correlations, predictive values and frequency of infected animals. Samples of tuberculosis-suggestive lesions collected by FIS sanitary inspection routine in slaughterhouses from 11 Brazilian states were analyzed. Isolation was the most sensitive technique, 94.54% (95% Credible Interval (CrI) 90.09%-97.65%), qPCR was 64.69% (95% CrI 54.41%-74.15%) sensitive and ELISA IDEXX™ 26.74% (95% CrI 22.82%-30.97%). Tests' specificities were 98.19% (95% CrI 95.75%-99.45%), 93.49% (95% CrI 79.28%-99.66%), 95.53% (95% CrI 91.71%-98.02%) respectively. Despite its low sensitivity, ELISA IDEXX™ was able to identify positive samples that were not detected by the other techniques. These samples had high probability to be true positives given ELISA's positive predictive value. The correlations between qPCR and isolation were neither biologically nor statistically significant. The low sensitivity of the qPCR is a limiting factor to its use as a post-mortem diagnosis in bovine tuberculosis suggestive lesions. Its use could be recommended in situations of high prevalence, or in parallel association with other tests, such as ELISA IDEXX™. ELISA IDDEX™ should not be used as a unique test, or in substitution of the other tests, for the post-mortem diagnosis of bovine tuberculosis due to its sensitivity.

Reasons behind the epidemiological situation of brucellosis in the Republic of Kazakhstan

Brucellosis is endemic in the Republic of Kazakhstan, particularly in agro-pastoral areas. The purpose of this research is to study the epidemiological situation of brucellosis in livestock recorded in the Republic of Kazakhstan, and to identify the reasons why anti-brucellosis measures were not effective. The research was performed on statistical data provided by the Republican Veterinary Laboratory (RVL), the Ministry of Agriculture of the Republic of Kazakhstan. The analysis touched upon the prevalence of Brucellosis in cattle and small ruminants (sheep and goats) in 13 regions of the Republic of Kazakhstan in 2012-2016. Aside from that, Research Institute for Biological Safety Problems conducted screening assays that involved 11,889 samples of blood and tissues from said animals. The risks of developing Brucellosis were assessed for each particular region. The comparison of studies conducted in 2012-2016 reveals an increase in the prevalence of Brucellosis in cattle in the following regions: West Kazakhstan, Karaganda Region and Pavlodar Region. For small ruminants, growing prevalence was observed in the Kostanay Region, Jambyl Region and Almaty Region. Between 2014 and 2016, the incidence rate had a growing trend, with a high in 2014 and 2015. The lowest prevalence rate during the following years (2012-2016) was in the Mangystau Region. The Enzyme-Linked Immunosorbent Assay (ELISE) test applied in the research among other tests provided the best results. The main risk factors involve epidemiology and sanitary measures, which are undertaken in the Republic of Kazakhstan, geography of the region with focuses of infection, and randomness of spread.

Bayesian estimation of sensitivity and specificity of culture- and PCR-based methods for the detection of six major non-O157 Escherichia coli serogroups in cattle feces

Non-O157 Shiga toxin-producing Escherichia coli (non-O157 STEC, O26, O45, O103, O111, O121, and O145) are foodborne pathogens of public health importance. Culture and PCR-based methods have been developed for the detection of these serogroups in cattle feces. The objectives of this study were to evaluate diagnostic sensitivity and specificity of PCR- and culture-based methods for the detection of the six non-O157 serogroups, and to estimate their true prevalence in cattle feces, using a Bayesian latent class modeling approach that accounts for conditional dependence among the three methods. A total of 576 fecal samples collected from the floor of pens of finishing feedlot cattle during summer 2013 were used. Fecal samples, suspended in E. coli broth, were enriched and subjected to three detection methods: culture (involving immunomagnetic separation with serogroup specific beads and plating on a selective medium), conventional (cPCR), and multiplex quantitative PCR (mqPCR) assays. Samples were considered serogroup positive if the sample or the recovered isolate tested positive by PCR for an O gene of interest; neither Shiga toxin (stx) nor intimin (eae) genes were assessed. Prior information on the performance of the three methods was elicited from three subject experts. Culture was generally the least sensitive and most specific of the 3 tests across serogroups, mqPCR was generally the most sensitive test and cPCR more specific than mqPCR. Sensitivity analysis indicated that posterior inferences on test performance and prevalence were susceptible to prior specification in cases where few or no detections present in the data for selected combinations of diagnostic methods (i.e. extreme category problem). Our results characterize performance of detection methods and true prevalence of non-O157 serogroups, thus informing necessary adjustments for test bias in risk modeling.

Evaluation of immunochromatographic assay as a field test for the diagnosis of caprine brucellosis

The present study was undertaken to assess the suitability of immunochromatographic assay (ICA) as a field test for the diagnosis of caprine brucellosis. Whole blood samples (570: 195 male goats, 375 female goats) were collected from selected organized herds and panjarapoles located in Southern Gujarat. Out of 570 animals tested, 19 (3.33%), 72 (12.63%) and 45 (7.89%) were positive by Rose Bengal plate test (RBPT), indirect ELISA (iELISA) and immunochromatographic assay (ICA) respectively. The sensitivity of RBPT and ICA vs iELISA was 26.39% and 61.11% respectively. Both the tests were 100% specific when compared with iELISA. Negative likelihood ratio for RBPT and ICA as compared to iELISA was 0.74 and 0.39 respectively. The negative predictive value for RBPT was 90.38% and 94.68% for ICA. However, the positive predictive values (PPV) for both the tests were 100%. McNemar chi-square test for independent data (with Yates’ correction) revealed significant difference in the positive proportion between RBPT vs iELISA as 9.30% and ICA vs iELISA as 4.91%. The concordance of iELISA with RBPT was moderate (k=0.385) while it was good (k=0.733) for ICA.

Prior Precision, Prior Accuracy, and the Estimation of Disease Prevalence Using Imperfect Diagnostic Tests

Estimates of disease prevalence in any host population are complicated by uncertainty in the outcome of diagnostic tests on individuals. In the absence of gold standard diagnostics (tests that give neither false positives nor false negatives), Bayesian latent class inference can be applied to batteries of diagnostic tests, providing posterior estimates of the sensitivity and specificity of each test, alongside posterior estimates of disease prevalence. Here we explore the influence of precision and accuracy of prior information on the precision and accuracy of posterior estimates of these key parameters. Our simulations use three diagnostic tests, yielding eight possible diagnostic outcomes per individual. Seven degrees of freedom allow the estimation of seven parameters: sensitivity and specificity of each test, and disease prevalence. We show that prior precision begets posterior precision but only when priors are accurate. We also show that analyses without gold standard can use imprecise priors as long as they are initialised with accuracy. Imprecise priors risk the divergence of MCMC chains towards inaccurate posterior estimates, if inaccurate initial values are used. We note that inaccurate priors can yield inaccurate and imprecise inference. Bounded priors should certainly not be used unless their accuracy is well established. Inaccurate estimates of sensitivity or specificity can yield wildly inaccurate estimates of disease prevalence. Our analyses are motivated by studies of bovine tuberculosis in a wild badger population.

Comparison of two indirect ELISA coating antigens for the detection of dairy cow antibodies against Pasteurella multocida

The ELISA is recognized as an efficient diagnostic tool for antibody detection, but there is no standard ELISA assay for detection of antibodies against hemorrhagic septicemia (HS) in cattle. The present study reports on an indirect ELISA assay for antibody detection of HS in dairy cows, and evaluates the sensitivity (Se) and specificity (Sp) of the method using a Bayesian approach. An indirect ELISA was developed with two types of heat extract antigens, Pasteurella multocida strains P-1256 and M-1404, as coating antigens. A checkerboard titration was employed using dairy cow sera immunized with P. multocida bacterin and colostrum-deprived calf sera. The concentrations of heat extract antigen (160μg/mL), sample serum (1:100) and goat anti-bovine immunoglobulin G labeled with horseradish peroxidase (1:2000) were optimal for the assay. The cut-off values were 0.147 and 0.128 for P-1256 and M-1404 coating antigens, and there were no differences in the results of tests with positive and negative sera (p<0.05). The characteristics of three diagnostic tests were evaluated using a one-population Bayesian model, assuming conditional dependence between two types of coating antigen-based ELISAs and indirect hemagglutination assay (IHA). A total of 415 sera samples from dairy cows without HS vaccination and no history of disease were tested. The Se and Sp of the P-1256 and M-1404 ELISAs were higher than those of the IHA. The Se and Sp of the P-1256 ELISA were 90.3% and 90.1%, while the Se and Sp of the M-1404 ELISA were 92.1% and 71.9%. The median values of Se and Sp from the IHA were 36.0% and 58.2%.

Evaluation of three serological tests for diagnosis of bovine brucellosis in smallholder farms in Pakistan by estimating sensitivity and specificity using Bayesian latent class analysis

The present study aimed to estimate the herd-level sensitivity (Se) and specificity (Sp) of three commonly used serological tests in naturally-infected cattle and buffalo in smallholder farms in Pakistan. Between February and June 2015, a cross-sectional study was carried out in five districts of Punjab (Kasur, Okara, Pakpattan, Jhelum, and Bhakkar) and two districts of Sindh (Badin and Thatta). Serum samples from mixed farms of cattle (n=441) and buffalo (n=621) were collected and tested using the Rose Bengal test (RBT), indirect ELISA (I-ELISA) and competitive ELISA (C-ELISA). A Bayesian latent class analysis (LCA) approach was used to estimate the Se and Sp of these three serological tests and the true herd-level prevalence in each district. The model was fitted under the assumption of conditional independence between three tests and also conditional dependence by including covariances between the two ELISAs. In addition, the model was fitted using three different shapes of beta distributions to incorporate prior information in the model. The test with the highest Se was the C-ELISA, with a range from 76.3% (95% PCI (Posterior Credibility Interval), 62.6-88.2%) to 81.4% (95% PCI, 68.2-92.8%). The RBT was found to have the highest Sp (99.1-99.4%) of the tests. The highest estimated herd-level prevalence, 45% (95% PCI, 32-59%), was found in Jhelum district and the lowest in Thatta district, 1.1% (95% PCI 0.04-6.0%). The results of this study identified some discrepancy between the published literature on the level of Se of these tests, especially for RBT. It appears that RBT has lower Se and higher Sp when used in the field conditions of the present study. Consequently, it is recommended that none of the evaluated tests should be performed in isolation for the diagnosis of bovine brucellosis in the field conditions of Pakistan, but the use of tests in combination, with RBT and C-ELISA used in parallel returning optimal Se and Sp, is warranted.

Development and standardization of an in-house indirect ELISA for detection of duck antibody to fowl cholera

Serological tests, such as agglutination and indirect hemagglutination assay (IHA), have been used to identify antibodies against Pasteurella multocida in poultry sera, but none are highly sensitive. An enzyme-linked immunosorbent assays (ELISA) has been used with varying degrees of success in attempts to monitor seroconversion in vaccinated poultry, but are not suitable for diagnosis. Commercial ELISA kits are available for chickens and turkeys, but not for ducks. The present study reports development and standardization of an in-house indirect ELISA for detection of duck antibody to fowl cholera. The characteristics of ELISA and IHA were analyzed using a one population Bayesian model assuming conditional dependence between the two diagnostic tests. An in-house indirect ELISA was developed using a heat extract antigen of P. multocida strain X-73 as a coating antigen and horseradish peroxidase conjugated goat anti-duck IgG antibody (dIgG-HRP). The checkerboard titration method was done using sera from ducks immunized with P. multocida bacterin as positive sera and 1day old duckling sera as negative sera. The heat extract antigen at 1μg/ml, sample serum at a dilution of 1:100, and dIgG-HRP 1:2000 were optimal concentrations for the assay. The cut-off value was 0.200. Of the duck sera, 89.05% (244/274) were considered seropositive by ELISA. Estimates for sensitivity and specificity of ELISA were higher than prior values with medians of 94.7% [95% posterior probability interval (PPI)=89.6-98.2%] and 87.2% (PPI=68.2-98.3%). Estimates for sensitivity of IHA were lower than prior values (median=97.6, PPI=93.2-99.7%) while the specificity was close to the prior value (median=76.5, PPI=65.8-85.4%). This finding suggests that an in-house indirect ELISA can be used to detect duck antibody to fowl cholera.

Empirical Bayes estimation of farm prevalence adjusting for multistage sampling and uncertainty in test performance: a Brucella cross-sectional serostudy in southern Kazakhstan

Estimation of farm prevalence is common in veterinary research. Typically, not all animals within the farm are sampled, and imperfect tests are used. Often, assumptions about herd sizes and sampling proportions are made, which may be invalid in smallholder settings. We propose an alternative method for estimating farm prevalence in the context of Brucella seroprevalence estimation in an endemic region of Kazakhstan. We collected 210 milk samples from Otar district, with a population of about 1000 cattle and 16 000 small ruminants, and tested them using an indirect ELISA. Individual-level prevalence and 95% confidence intervals were estimated using Taylor series linearization. A model was developed to estimate the smallholding prevalence, taking into account variable sampling proportions and uncertainty in the test accuracy. We estimate that 73% of households that we sampled had at least one Brucella-seropositive animal (95% credible interval 68-82). We estimate that 58% (95% confidence interval 40-76) of lactating small ruminants and 14% (95% confidence interval 1-28) of lactating cows were seropositive. Our results suggest that brucellosis is highly endemic in the area and conflict with those of the official brucellosis-testing programme, which found that in 2013 0% of cows and 1·7% of small ruminants were seropositive.

Latent class evaluation of three serological tests for the diagnosis of human brucellosis in Bangladesh

Background

A Bayesian latent class evaluation was used to estimate the true prevalence of brucellosis in livestock farmers and patients with prolonged pyrexia (PP) and to validate three conditionally dependent serological tests: indirect ELISA (iELISA), Rose Bengal Test (RBT), and standard tube agglutination (STAT). A total of 335 sera from livestock farmers and 300 sera from PP patients were investigated.

Results

The true prevalence of brucellosis in livestock farmers and PP patients was estimated to be 1.1 % (95 % credibility interval (CrI) 0.1–2.8) and 1.7 % (95 % CrI 0.2–4.1), respectively. Specificities of all tests investigated were higher than 97.8 % (95 % CrI 96.1–99.9). The sensitivities varied from 68.1 % (95 % CrI 54.5–80.7) to 80.6 % (95 % CrI 63.6–93.8). The negative predictive value of all the three tests in both populations was very high and more than 99.5 % (95 % CrI 98.6–99.9). The positive predictive value (PPV) of all three tests varied from 27.9 % (95 % CrI 3.6–62.0) to 36.3 % (95 % CrI 5.6–70.5) in livestock farmers and 39.8 % (95 % CrI 6.0–75.2) to 42.7 % (95 % CrI 6.4–83.2) in patients with PP. The highest PPV were 36.3 % for iELISA and 42.7 % for RBT in livestock farmers and pyrexic patients, respectively.

Conclusions

In such a low prevalence scenario, serology alone does not help in diagnosis and thereby therapeutic decision-making. Applying a second test with high specificity and/or testing patients having history of exposure with known risk factors and/or testing patients having some clinical signs and symptoms of brucellosis may increase the positive predictive value of the serologic tests.

Electronic supplementary material

The online version of this article (doi:10.1186/s41182-016-0031-8) contains supplementary material, which is available to authorized users.

Bovine and Caprine Brucellosis in Bangladesh: Bayesian evaluation of four serological tests, true prevalence, and associated risk factors in household animals

A cross-sectional study was carried out to estimate the true prevalence of Brucella spp. and identify allied risk factors/indicators associated with brucellosis in the Dinajpur and Mymensingh districts of Bangladesh. A total 320 stratified random blood samples were collected and tested in parallel for Brucella antibodies using Rose Bengal (RBT), slow agglutination (SAT), and indirect and competitive ELISA. In addition, a structured questionnaire was administered to each household herd owner to gather information regarding potential risk factors. Both univariate and multivariate logistic regression analyses were used to identify potential risk factors or indicators at animal level. A Bayesian approach was used to estimate the true prevalence of brucellosis along with the test performances (Se and Sp). The estimated animal level true prevalence in cattle was 9.70 % (95 % CPI 5.0-16 %) and in goat 6.3 % (95 % CPI 2.8-11.0 %). The highest sensitivity was achieved by SAT ranges from 69.6 to 78.9 %, and iELISA was found to be more specific (97.4 to 98.8 %) in comparison with other tests. On the other hand, a significant level of (P < 0.05) Brucella seropositivity was found in cattle that breed naturally compared with those that undergo artificial insemination. In goats, exotic breeds were significantly associated (P < 0.05) with Brucella seroprevalence compared with indigenous breeds. Goats with a previous records of abortion and/or retained placenta were also found to have significant levels (P < 0.05). Cows with previous abortion records showed higher odds (18 times) of being seropositive. None of the evaluated tests can be recommended to apply alone for the diagnosis of bovine and caprine brucellosis.

Evaluation of three competitive ELISAs and a fluorescence polarisation assay for the diagnosis of bovine brucellosis

Bovine brucellosis is an infectious disease of worldwide public health and economic importance. The usual tests for the diagnosis of this disease include the Rose-Bengal test (RBT), complement fixation test (CFT), serum agglutination test (SAT) and indirect ELISA. New tests such as competitive ELISAs (C-ELISA) and fluorescence polarisation assay (FPA) have been developed. However, C-ELISA may correspond to different protocols and a wide variation may exist in their diagnostic performance. The aim of this study was to evaluate three commercially available C-ELISA kits (C-ELISA1-3) and FPA for the diagnosis of bovine brucellosis and compare test performance with RBT, CFT, indirect ELISA and FPA. Sera submitted to EU laboratories in 2011 from 5111 adult cattle were tested. Individual test sensitivities (Se) and specificities (Sp) were estimated. Threshold assessment using the receiver operating characteristic method was also performed. The most sensitive tests were FPA (99.0%; 95% confidence interval [CI], 97.9-100%), C-ELISA1 (98.4%; 95% CI, 97.0-99.8%) and RBT (97.7%; 95% CI, 95.9-99.3%). The most specific tests were CFT (99.98%; 95% CI, 99.93-100%), SAT (99.98%; 95% CI, 99.93-100%) and RBT (99.89%; 95% CI, 99.79-99.99%). Among the new tests, none of the three C-ELISA kits studied could be recommended as a single screening test because of their low specificity, especially when used in a herd. C-ELISA3 could not be recommended as confirmatory test on individual animals to determine whether false positive serological test results had occurred.

Serological and Molecular Evidence of Q Fever in Domestic Ruminants in Bangladesh

The objective of this study was to know the herd and animal level prevalence of Q fever in domestic ruminants in some selected districts in Bangladesh. Randomly collected 111 bulk milk and 94 sera samples of cattle, sheep, and goats were tested by indirect ELISA (iELISA). DNA extracted from 23 aborted fetal membranes was analyzed by real time (rt) PCR. The positive cut-off value of iELISA in bulk milk and individual animal sera was ≥30% and ≥40%, respectively. The overall herd level prevalence of Q fever in dairy cattle was 15.6%. The prevalence of Q fever in dairy cattle was significantly higher in Sirajganj in comparison to Satkhira District (P < 0.01). The overall seroprevalence of Q fever in domestic ruminants was 5.06%. Although statistically insignificant, the seroprevalence of Q fever was relatively higher in sheep (9.52%) in comparison to goats (3.33%) and cattle (3.57%). Out of 23 aborted fetal membranes, only one sheep placenta was positive in rt PCR. Q fever is present in all of the three important species of domestic ruminants in Bangladesh. It may have some role in sheep abortion as the seroprevalence is relatively higher and also one sheep placenta is rt PCR positive.

Evaluation of the sensitivity and specificity of an enzyme-linked immunosorbent assay for diagnosing brucellosis in African buffalo (Syncerus caffer)

Brucellosis is a disease of veterinary and public health importance worldwide. In sub-Saharan Africa, where the bacterium Brucella abortus has been identified in several free-ranging wildlife species, successful disease control may be dependent on accurate detection in wildlife reservoirs, including African buffalo (Syncerus caffer). We estimated the sensitivity and specificity of a commercial enzyme-linked immunosorbent assay (ELISA) (IDEXX Brucellosis Serum Ab test, IDEXX Laboratories, Westbrook, Maine, USA) for B. abortus based on a data set of 571 serum samples from 258 buffalo in the Kruger National Park, South Africa. We defined a pseudogold standard test result as those buffalo that were consistently positive or negative on two additional serologic tests, namely, the rose bengal test (RBT) and the complement fixation test (CFT). The ELISA's cutoff value was selected using receiver operating characteristics analysis, the pseudogold standard, and a threshold criterion that maximizes the total sensitivity and specificity. Then, we estimated the sensitivity and specificity of all three tests using Bayesian inference and latent class analysis. The ELISA had an estimated sensitivity of 0.928 (95% Bayesian posterior credibility interval [95% BCI] = 0.869-0.974) and specificity of 0.870 (95% BCI = 0.836-0.900). Compared with the ELISA, the RBT had a higher estimated sensitivity of 0.986 (95% BCI = 0.928-0.999), and both the RBT and CFT had higher specificities, estimated to be 0.992 (95% BCI = 0.971-0.996) and 0.998 (95% BCI = 0.992-0.999), respectively. Therefore, no single serologic test perfectly detected the antibody. However, after adjustment of cutoff values for South African conditions, the IDEXX Brucellosis Serum Ab Test may be a valuable additional screening test for brucellosis in Kruger National Park's African buffalo.

Assessment of zoonotic transmission of Giardia and Cryptosporidium between cattle and humans in rural villages in Bangladesh

Giardia and Cryptosporidium are important causes of diarrhoea in Bangladesh. The high prevalence of both parasites in humans and cattle in rural Bangladesh and the common use of water ponds by village inhabitants and their animals suggest a potential for zoonotic transmission. Direct transmission of Giardia and Cryptosporidium between cattle and their handlers and indirect transmission through water ponds was investigated. Faecal/stool samples were collected from 623 calves and 125 calf handlers in a cross-sectional survey. In two villages, water samples were collected monthly from water ponds and faecal/stool samples were collected monthly from inhabitants and their cattle. Giardia cysts and Cryptosporidium oocysts were detected in water samples and in faecal/stool samples and positive samples were genotyped, to determine their human or animal origin. The prevalence of Giardia and Cryptosporidium in calves was 22% and 5% respectively. In calf handlers, the prevalence of Giardia and Cryptosporidium was 11.2% and 3.2% respectively. Both in the cross-sectional survey and in the longitudinal study in the villages, G. duodenalis assemblage E was most prevalent in calves, while in humans assemblage AII, BIII and BIV were found. In cattle, Cryptosporidium parvum, C. bovis and C. andersoni were identified, but no Cryptosporidium sequences were obtained from humans. Giardia and Cryptosporidium were detected in 14/24 and 12/24 water samples respectively. G. duodenalis assemblage E and BIV (-like), as well as C. andersoni and C. hominis were identified. Although the presence of Giardia and Cryptosporidium in both water ponds suggests that water-borne transmission of Giardia and Cryptosporidium is possible, the genotyping results indicate that there is no significant direct or indirect (water-borne) transmission of Giardia between cattle and people in this area of rural Bangladesh. No conclusions could be drawn for Cryptosporidium, because of the low number of sequences that were obtained from human and water samples.

Bayesian estimation of diagnostic accuracy of a new bead-based antibody detection test to reveal Toxoplasma gondii infections in pig populations

The success of a Toxoplasma gondii surveillance program in European pig production systems depends partly on the quality of the test to detect infection in the population. The test accuracy of a recently developed serological bead-based assay (BBA) was investigated earlier using sera from experimentally infected animals. In this study, the accuracy of the BBA was determined by the use of sera from animals from two field subpopulations. As no T. gondii infection information of these animals was available, test accuracy was determined through a Bayesian approach allowing for conditional dependency between BBA and an ELISA test. The priors for prevalence were based on available information from literature, whereas for specificity vague non-informative priors were used. Priors for sensitivity were based either on available information or specified as non-informative. Posterior estimates for BBA sensitivity and specificity were (mode) 0.855 (Bayesian 95% credibility interval (bCI) 0.702-0.960) and 0.913 (bCI 0.893-0.931), respectively. Comparing the results of BBA and ELISA, sensitivity was higher for the BBA while specificity was higher for ELISA. Alternative priors for the sensitivity affected posterior estimates for sensitivity of both BBA and ELISA, but not for specificity. Because the difference in prevalence between the two subpopulations is small, and the number of infected animals is small as well, the precision of the posterior estimates for sensitivity may be less accurate in comparison to the estimates for specificity. The estimated value for specificity of BBA is at least optimally defined for testing pigs from conventional and organic Dutch farms.

Establishment of indirect enzyme-linked immunosorbent assay for artificial musk

Anti-inflammatory component (AIC) known as an important constituent of artificial musk exhibits bioactive effects on many pharmacological models. This study describes an immunochemical assay for the quality control of artificial musk in traditional Chinese medicine using an enzyme-linked immunosorbent assay. A polyclonal antibody against AIC was produced by rabbit. The method, at an effective measuring range of 3.13-200 ng/ml of AIC, 3 ng/ml limit of detection, and no cross-reaction with natural musk, successfully detected artificial musk in many traditional Chinese prescriptions containing artificial musk. The results demonstrated that a novel and reliable assay system for detection of artificial musk was generated.

Estimation of diagnostic test accuracy without full verification: a review of latent class methods

The performance of a diagnostic test is best evaluated against a reference test that is without error. For many diseases, this is not possible, and an imperfect reference test must be used. However, diagnostic accuracy estimates may be biased if inaccurately verified status is used as the truth. Statistical models have been developed to handle this situation by treating disease as a latent variable. In this paper, we conduct a systematized review of statistical methods using latent class models for estimating test accuracy and disease prevalence in the absence of complete verification.

Brucellosis in dairy cattle and goats in northern Ecuador

The purpose of this study was to conduct a convenience study for brucellosis prevalence in dairy-producing animals in northern Ecuador. In total, 2,561 cows and 301 goats were tested. Cattle sera were tested using the Rose Bengal card antigen test (RBCT), yielding an overall apparent prevalence of 5.5% (95% confidence interval [95% CI] = 4.7-6.5%) and true prevalence of 7.2% (95% CI = 6.0-8.5%). Prevalence varied by herd size and was highest in larger commercial herds. Polymerase chain reaction was used to test goat milk and lymph nodes, resulting in 9% and 8% positivity, respectively. The RBCTs from goat sera yielded an adjusted true prevalence of 17.8% (95% CI = 6.2-44.2%). Our findings are similar to other overall prevalence estimates for dairy herds but show higher prevalence in commercial herds compared with small groups (less than five animals). We also identify urban milking goats living in metropolitan Quito as a potential source of zoonosis.

Evaluation of different enzyme-linked immunosorbent assays for the diagnosis of brucellosis due to Brucella melitensis in sheep

Six serological assays for the diagnosis of ovine brucellosis, due to Brucella melitensis were evaluated. Reference serum samples from sheep of known B. melitensis infection status (n=118) were assessed using the Rose Bengal test (RBT), complement fixation test (CFT) and four commercial enzyme-linked immunosorbent assays (ELISAs), including two indirect ELISAs (iELISAs), one competitive ELISA (cELISA) and one blocking ELISA (bELISA). The highest differential positive rates (DPR) were obtained with the cELISA and bELISA, while the lowest DPR was estimated using iELISAs. A latent class analysis was performed to estimate the accuracy of the CFT, RBT and bELISA using 1827 sera from sheep undergoing testing as part of a surveillance and control programme. Lower sensitivity and specificity were obtained for the three serological tests when the field samples were used. A higher DPR was achieved by the CFT, compared to bELISA and RBT. The results suggest that ELISAs, and particularly the bELISA, might be suitable for inclusion in the European Union legislation on intra-community trade for diagnosing B. melitensis infection in sheep, as it has a similar test performance compared to the RBT.