Assessing the sensitivity of bovine tuberculosis surveillance in Canada’s cattle population, 2009–2013

Assessment of the Current Surveillance System for Human Leptospirosis in Ecuador by Decision Analytic Modeling

Leptospirosis is a globally disseminated zoonotic disease with no national surveillance systems. On the other hand, surveillance is crucial for improving population health, and surveillance systems produce data that motivates action. Unfortunately, like many other countries, Ecuador put in place a monitoring system that has never been tested. The goal of this study was to use scenario tree modeling to assess the sensitivity of Ecuador's current national surveillance system to human leptospirosis as the basis for an economic assessment of the system. We created a decision-tree model to analyze the current system's sensitivity. The inputs were described as probabilities distributions, and the model assessed the program's sensitivity as an output. The model also considers the geographical and weather variations across Ecuador's three continental regions: Andean, Amazonia, and the Coast. Several data sources were used to create the model, including leptospirosis records from Ecuador's Ministry of Public Health, national and international literature, and expert elicitation, all of which were incorporated in a Bayesian framework. We were able to determine the most critical parameters influencing each scenario's output (CSU) sensitivity through sensitivity analysis. The Coast region had the best sensitivity scenario, with a median of 0.85% (IC 95% 0.41-0.99), followed by the Amazonia with a median of 0.54% (CI 95% 0.18-0.99) and the Andes with a median of 0.29% (CI 95% 0.02-0.89). As per the sensitivity study, the most influential criteria on the system's sensitivity were "Attendance or probability of going to a health center" and "probability of having symptoms," notably for the Coast and Amazonia Regions.

Evaluation of the effectiveness of the surveillance system for tuberculosis in cattle in Spain

In Spain, the eradication of tuberculosis (TB) in cattle has had some setbacks and therefore we need to re-evaluate the current surveillance strategies. The Spanish cattle TB surveillance system consists of three components: a) routine skin testing, b) slaughterhouse surveillance, and c) pre-movement controls. Our objectives were to assess the effectiveness of the whole surveillance system and evaluate the relative contribution of each of those components, both at national and at the province level. The effectiveness was estimated based on both the sensitivity of detection per year and the time until detection. Moreover, we evaluated the impact of different factors on that effectiveness. We used a stochastic model that simulated the spread of Mycobacterium tuberculosis-complex (MTC) infection within cattle herds that was modified to incorporate the three components of TB surveillance. Input data, at the province level, on cattle movements off-farm or the frequency of the routine screening were provided by the Spanish Ministry for Agriculture, Fisheries and Food. Under the current conditions, 96.1% of Spanish herds were detected within one year after their infection (i.e. mean sensitivity of TB surveillance), although that detection took on average 178 days. The surveillance system effectiveness was highly dependent on the routine skin testing, responsible for the detection of almost 90% of the infected herds, while slaughterhouse surveillance and pre-movement controls contributed only to the identification of a small proportion of infected herds. We observed substantial differences in the effectiveness of the surveillance components among Spanish provinces, although in general, the sensitivities were high. The most influential factor on the efficiency of TB detection in Spain was, by far, the frequency of routine controls, followed by the sensitivity of the test used. In a context of reduced funding for cattle TB eradication, the frequency of testing should be adapted based on risk-based surveillance strategies, i.e. efforts should focus on herds more likely to be infected, but also in herds more likely to infect other herds. While slaughterhouse surveillance seems a cost-effective strategy, the use of pre-movement testing at least in areas of low incidence should be further evaluated.

Cattle movements in Northern Ireland form a robust network: implications for disease management

The movements of undetected infected animals can facilitate long-distance pathogen spread, making control and eradication difficult by (re)infecting disease-free populations. Characterising movement patterns is essential in understanding pathogen spread and how potential interventions, particularly animal movement restrictions, could help as a control mechanism. In Northern Ireland (NI), cattle movements are important contributors to a significant portion of agricultural trade. They can be disrupted due to statutory interventions, for example, during bovine tuberculosis (bTB) control. Identifying populations at risk of becoming infected would allow for improved resource allocation. This could be through targeting herds with an above-average risk of becoming infected or spreading (amplifying) infection, and restricting their movement to manage future outbreaks. In this study, cattle movements were investigated using social network analysis (SNA) at the monthly temporal scale across NI during 2010-2015. Targeted and random herd restrictions were compared and their impact on the structure and connectivity of the networks' was assessed (e.g. connected component subgraphs). This work was contextualised in relation to bTB, the most persistent infectious disease currently impacting agriculture in NI, where reduced connectivity would represent potential reduced vulnerability from infection introduction. There was seasonal variation in network size and level of connectivity with spring and autumn being the largest and most connected due to common farming practices in NI. Across the study period, there was limited inter-annual variation in global network metrics. On average there were 6.28 movements between each pair of nodes each month, low reciprocity (mean of 0.155) and the networks were moderately accessible with an average path length of 4.28. Movements were not confined to within each disease management area but frequently occurred between these areas (mean assortativity of -0.0731) and herds with high degree interacted with herds of low degree (mean assortativity of -0.351). The Giant Weakly Connected Component (GWCC) spanned most of the networks (between 75% and 100% of nodes); however the Giant Strongly Connected Component (GSCC) included, at most, 23% of the network. There was heterogeneous contributions across NI with little participation in the GSCC from some disease management areas, and the GSCC was comprised predominantly of 'beef breeders', 'beef rearers', and 'other/mixed' type herds. Targeted restrictions were more effective at fragmenting the network than randomly restricting movements when 25% of nodes or more were removed. Cattle networks in NI are extremely interconnected and robust to movement restrictions, suggesting potential vulnerability to movement-facilitated pathogen spread, such as bTB.

The spread of bovine tuberculosis in Canadian shared pastures: Data, model, and simulations

Bovine tuberculosis (bTB), caused by Mycobacterium bovis, is a chronic disease typical of cattle. Nonetheless, it can affect many mammals including humans, making it one of the most widespread zoonotic diseases worldwide. In industrialized countries, the main pathways of introduction of bTB into a herd are animal trade and contact with infected wildlife. In addition, for slow-spreading diseases with a long latent period such as bTB, shared seasonal pastures might be a between-herd transmission pathway, indeed farmers might unknowingly send infected animals to the pasture, since clinical signs are rarely evident in early infection. In this study, we developed a dynamic stochastic model to represent the spread of bTB in pastures. This was tailored to Canadian cow-calf herds, as we calibrated the model with data sourced from a recent bTB outbreak in Western Canada. We built a model for a herd with seasonal management, characterized by its partition into a group staying in the main facility and the remaining group(s) moving to summer pastures. We used this model to estimate the time of the first introduction of bTB into the herd. Furthermore, we expanded the model to include herds categorized as high-risk contacts with the index herd, in order to estimate the potential for disease spread on shared pastures. Finally, we explored two control scenarios to be applied to high-risk farms after the outbreak detection. Our results showed that the first introduction likely happened 3 to 5 years prior to the detection of the index herd, and the probability of bTB spreading in pastures was low, but not negligible. Nevertheless, the surveillance system currently in place was effective to detect potential outbreaks.

Optimal surveillance strategies for bovine tuberculosis in a low-prevalence country

Bovine tuberculosis (bTB) is a chronic disease of cattle that is difficult to control and eradicate in part due to the costly nature of surveillance and poor sensitivity of diagnostic tests. Like many countries, bTB prevalence in Uruguay has gradually declined to low levels due to intensive surveillance and control efforts over the past decades. In low prevalence settings, broad-based surveillance strategies based on routine testing may not be the most cost-effective way for controlling between-farm bTB transmission, while targeted surveillance aimed at high-risk farms may be more efficient for this purpose. To investigate the efficacy of targeted surveillance, we developed an integrated within- and between-farm bTB transmission model utilizing data from Uruguay's comprehensive animal movement database. A genetic algorithm was used to fit uncertain parameter values, such as the animal-level sensitivity of skin testing and slaughter inspection, to observed bTB epidemiological data. Of ten alternative surveillance strategies evaluated, a strategy based on eliminating testing in low-risk farms resulted in a 40% reduction in sampling effort without increasing bTB incidence. These results can inform the design of more cost-effective surveillance programs to detect and control bTB in Uruguay and other countries with low bTB prevalence.