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Wright E, Jessen LR, Tompson A, Rutland C, Singleton D, Battersby I, Gajanayake I, Mosher M, Pfleger S, Gemmill T, Sparks T, Sørensen TM, Allerton F. Influencing attitudes towards antimicrobial use and resistance in companion animals-the impact on pet owners of a short animation in a randomized controlled trial. JAC Antimicrob Resist 2024; 6:dlae065. [PMID: 38716404 PMCID: PMC11073752 DOI: 10.1093/jacamr/dlae065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 04/01/2024] [Indexed: 06/29/2024] Open
Abstract
Objectives Antimicrobial resistance (AMR) is a vital One Health issue; the rational use of antimicrobials is essential to preserve their efficacy. Veterinarians cite pressure from pet owners as a contributor to antimicrobial prescription. Engaging pet owners in antimicrobial stewardship could reduce this pressure. A short educational animation could facilitate communication of this message. The impact of the animation on participant's opinions relating to antimicrobial prescribing and awareness of AMR was assessed via a randomized controlled trial. Methods A survey was created based on the health belief model. Owners attending six UK veterinary centres were randomized to the intervention or control group (ratio 1:1). All owners completed an agreement level survey of two questions followed by 18 statements scored using a Likert agreement scale. The control group responded without interruption, whereas the animation group was shown the animation after answering the first two questions and five statements. Results In total, 647 owners participated in the study; 350 complete responses were analysed. Responses to 10 of 13 statements asked after the animation were significantly different (all P < 0.050) between groups, whereas there was no significant difference between groups in response to any of the statements asked before the animation. The animation group were more likely to agree that lower antimicrobial use would help maintain future efficacy (P < 0.001) and that requesting antimicrobials from their vet could increase unnecessary use (P < 0.001). The animation group were more likely to disagree that they would expect antimicrobials if their pet had diarrhoea (P = 0.048). Conclusions Pet owners that watched a short AMR engagement animation displayed greater awareness of the impact of AMR and were more likely to support measures in line with antimicrobial stewardship. This behavioural-nudge resource could support owners towards contributing to a multi-faceted approach to AMR.
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Affiliation(s)
- Emma Wright
- The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Lisbeth Rem Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C, 1870, Denmark
| | - Alice Tompson
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Catherine Rutland
- Simplyhealth, Hambledon House, Waterloo Court, Andover, Hampshire, SP10 1LQ, UK
| | - David Singleton
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Ian Battersby
- Mars Veterinary Health, 18101 SE 6th Way, Vancouver, WA, 98683, USA
| | - Isuru Gajanayake
- Willows Veterinary Centre and Referral Service part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - Margo Mosher
- Mars Veterinary Health, 18101 SE 6th Way, Vancouver, WA, 98683, USA
| | - Sharon Pfleger
- NHS Highland, Public Health Directorate, Larch House, Stoneyfield Business Park, Inverness, IV2 7PA, UK
| | - Toby Gemmill
- Willows Veterinary Centre and Referral Service part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, B90 4NH, UK
| | - Tim Sparks
- Waltham Petcare Science Institute, Freeby Lane, Waltham on the Wolds, Melton Mowbray, Leicestershire, LE14 4RT, UK
| | - Tina M Sørensen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Dyrlægevej 16, Frederiksberg C, 1870, Denmark
| | - Fergus Allerton
- Willows Veterinary Centre and Referral Service part of Linnaeus Veterinary Limited, Highlands Road, Shirley, Solihull, B90 4NH, UK
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Pegram C, Diaz-Ordaz K, Brodbelt DC, Chang YM, Tayler S, Allerton F, Prisk L, Church DB, O’Neill DG. Target trial emulation: Do antimicrobials or gastrointestinal nutraceuticals prescribed at first presentation for acute diarrhoea cause a better clinical outcome in dogs under primary veterinary care in the UK? PLoS One 2023; 18:e0291057. [PMID: 37792702 PMCID: PMC10550114 DOI: 10.1371/journal.pone.0291057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023] Open
Abstract
Target trial emulation applies design principles from randomised controlled trials to the analysis of observational data for causal inference and is increasingly used within human epidemiology. Veterinary electronic clinical records represent a potentially valuable source of information to estimate real-world causal effects for companion animal species. This study employed the target trial framework to evaluate the usefulness on veterinary observational data. Acute diarrhoea in dogs was used as a clinical exemplar. Inclusion required dogs aged ≥ 3 months and < 10 years, presenting for veterinary primary care with acute diarrhoea during 2019. Treatment strategies were: 1. antimicrobial prescription compared to no antimicrobial prescription and 2. gastrointestinal nutraceutical prescription compared to no gastrointestinal nutraceutical prescription. The primary outcome was clinical resolution (defined as no revisit with ongoing diarrhoea within 30 days from the date of first presentation). Informed from a directed acyclic graph, data on the following covariates were collected: age, breed, bodyweight, insurance status, comorbidities, vomiting, reduced appetite, haematochezia, pyrexia, duration, additional treatment prescription and veterinary group. Inverse probability of treatment weighting was used to balance covariates between the treatment groups for each of the two target trials. The risk difference (RD) of 0.4% (95% CI -4.5% to 5.3%) was non-significant for clinical resolution in dogs treated with antimicrobials compared with dogs not treated with antimicrobials. The risk difference (RD) of 0.3% (95% CI -4.5% to 5.0%) was non-significant for clinical resolution in dogs treated with gastrointestinal nutraceuticals compared with dogs not treated with gastrointestinal nutraceuticals. This study successfully applied the target trial framework to veterinary observational data. The findings show that antimicrobial or gastrointestinal prescription at first presentation of acute diarrhoea in dogs causes no difference in clinical resolution. The findings support the recommendation for veterinary professionals to limit antimicrobial use for acute diarrhoea in dogs.
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Affiliation(s)
- Camilla Pegram
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Karla Diaz-Ordaz
- Department of Statistical Science, University College London, London, United Kingdom
| | - Dave C. Brodbelt
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Sarah Tayler
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Fergus Allerton
- Willows Veterinary Centre & Referral Centre, Solihull, United Kingdom
| | - Lauren Prisk
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - David B. Church
- Clinical Sciences and Services, The Royal Veterinary College, Hatfield, Herts, United Kingdom
| | - Dan G. O’Neill
- Pathobiology and Population Sciences, The Royal Veterinary College, Hatfield, Herts, United Kingdom
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3
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Taylor DD, Scallan Walter EJ. Colorado pet owners' perceptions of and attitudes towards antimicrobial drug use and resistance. Vet Rec 2023; 192:e2583. [PMID: 36692979 DOI: 10.1002/vetr.2583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/04/2022] [Accepted: 12/06/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Antimicrobial drug (AMD) use in companion animal medicine may contribute to antimicrobial resistance (AMR) in both pets and humans. However, pet owners' attitudes and perceptions regarding AMD use and AMR have not been extensively studied in the United States. METHODS A cross-sectional survey at five Colorado veterinary hospitals collected information about pet owners' knowledge and perceptions of AMD use and AMR, adherence with AMD treatment instructions and the role of the veterinarian in the AMD prescribing process. RESULTS The pet owners surveyed did not have an adequate understanding of AMR and were unaware of the potential human health impact of AMD use in pets. However, most pet owners reported adherence with veterinary prescription instructions and indicated that they trusted their veterinarian to make appropriate decisions for their pets. LIMITATIONS The cross-sectional design focusing on Colorado pet owners limits the generalisability of the results. Selection and social desirability biases may have occurred, which could have affected who participated and how participants responded to statements. CONCLUSIONS Pet owners play an important role in the AMD prescription process, and their lack of AMR understanding should be addressed in antimicrobial stewardship plans. Further research on how to effectively incorporate pet owners into stewardship interventions is needed.
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Affiliation(s)
- Daniel D Taylor
- Colorado School of Public Health, Colorado Integrated Food Safety Center of Excellence, Aurora, Colorado, USA
| | - Elaine J Scallan Walter
- Colorado School of Public Health, Colorado Integrated Food Safety Center of Excellence, Aurora, Colorado, USA
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4
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Fajt VR, Lehenbauer TW, Plummer PJ, Robbins RC, Scheftel JM, Singer RS, Canon AJ, Frey E, Gaunt PS, Papich MG, Parker TM, Brookshire C, Cervantes H, Jay-Russell MT, Schnabel LV, Smith DR, Wright LR, Costin M. A call to action for veterinarians and partners in animal health to collect antimicrobial use data for the purposes of supporting medical decision-making and antimicrobial stewardship. J Am Vet Med Assoc 2022; 260:853-859. [PMID: 35271460 DOI: 10.2460/javma.21.09.0431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Taylor DD, Martin JN, Scallan Walter EJ. Survey of companion animal veterinarians' antimicrobial drug prescription practices and awareness of antimicrobial drug use guidelines in the United States. Zoonoses Public Health 2022; 69:277-285. [DOI: 10.1111/zph.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/13/2021] [Accepted: 11/17/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Daniel D. Taylor
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
| | - Jennifer N. Martin
- College of Agricultural Sciences Department of Animal Sciences Colorado State University Fort Collins Colorado USA
| | - Elaine J. Scallan Walter
- Colorado School of Public Health Colorado Integrated Food Safety Center of Excellence Aurora Colorado USA
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Comparison of the Therapeutic Effect of Treatment with Antibiotics or Nutraceuticals on Clinical Activity and the Fecal Microbiome of Dogs with Acute Diarrhea. Animals (Basel) 2021; 11:ani11061484. [PMID: 34063855 PMCID: PMC8223982 DOI: 10.3390/ani11061484] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 11/26/2022] Open
Abstract
Simple Summary Acute diarrhea in dogs is one of the most common reasons for veterinary visits. Although this disorder is generally self-limiting, antibiotics are still frequently used as treatment for acute diarrhea in clinical practice. Antimicrobial resistance represents a major challenge for public health and requires immediate and drastic solutions. To date, the emergence and spread of antimicrobial resistance has been attributed to the misuse or indiscriminate use of antibiotics. The aim of this study is to compare the effects on clinical activity and fecal microbiota of the administration of an antibiotic combination in comparison to a nutraceutical product in dogs with acute non-hemorrhagic diarrhea. The results of the present study suggest that this nutraceutical treatment had a similar clinical effect compared to the antibiotic formulation and may represent an alternative to commonly used antimicrobial therapy. Abstract Dogs with acute diarrhea are often presented to clinical practice and, although this generally represents a self-limiting condition, antibiotics are still frequently used as treatment. The aim of this study was to evaluate the effects in dogs with acute non-hemorrhagic diarrhea of the administration of an antibiotic combination in comparison to a nutraceutical product. Thirty dogs were enrolled and randomly assigned to two groups: 15 dogs (group A) received a nutraceutical commercial product while 15 dogs (group B) received an antimicrobial combination of metronidazole and spiramycin. For each dog, the Canine Acute Diarrhea Severity Index, the fecal microbiota and the Dysbiosis Index were assessed. Both stool consistency and frequency decreased on day 2 in the dogs of group A compared to baseline, while in group B, these parameters significantly decreased at days 3 and 4. The global concern for rising antibiotic resistance associated with indiscriminate use of antimicrobials, in both humans and animals, suggests the necessity of avoiding empirical and injudicious use of these molecules in diarrheic dogs. These results suggest that the nutraceutical treatment had a similar clinical effect compared to the antibiotic formulation, representing a valid antibiotic-sparing therapeutic approach in canine acute diarrhea.
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Lustgarten JL, Zehnder A, Shipman W, Gancher E, Webb TL. Veterinary informatics: forging the future between veterinary medicine, human medicine, and One Health initiatives-a joint paper by the Association for Veterinary Informatics (AVI) and the CTSA One Health Alliance (COHA). JAMIA Open 2020; 3:306-317. [PMID: 32734172 PMCID: PMC7382640 DOI: 10.1093/jamiaopen/ooaa005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/26/2019] [Accepted: 02/26/2020] [Indexed: 12/25/2022] Open
Abstract
Objectives This manuscript reviews the current state of veterinary medical electronic health records and the ability to aggregate and analyze large datasets from multiple organizations and clinics. We also review analytical techniques as well as research efforts into veterinary informatics with a focus on applications relevant to human and animal medicine. Our goal is to provide references and context for these resources so that researchers can identify resources of interest and translational opportunities to advance the field. Methods and Results This review covers various methods of veterinary informatics including natural language processing and machine learning techniques in brief and various ongoing and future projects. After detailing techniques and sources of data, we describe some of the challenges and opportunities within veterinary informatics as well as providing reviews of common One Health techniques and specific applications that affect both humans and animals. Discussion Current limitations in the field of veterinary informatics include limited sources of training data for developing machine learning and artificial intelligence algorithms, siloed data between academic institutions, corporate institutions, and many small private practices, and inconsistent data formats that make many integration problems difficult. Despite those limitations, there have been significant advancements in the field in the last few years and continued development of a few, key, large data resources that are available for interested clinicians and researchers. These real-world use cases and applications show current and significant future potential as veterinary informatics grows in importance. Veterinary informatics can forge new possibilities within veterinary medicine and between veterinary medicine, human medicine, and One Health initiatives.
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Affiliation(s)
- Jonathan L Lustgarten
- Association for Veterinary Informatics, Dixon, California, USA.,VCA Inc., Health Technology & Informatics, Los Angeles, California, USA
| | | | - Wayde Shipman
- Veterinary Medical Databases, Columbia, Missouri, USA
| | - Elizabeth Gancher
- Department of Infectious diseases and HIV medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Tracy L Webb
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Singleton DA, Noble PJM, Sánchez-Vizcaíno F, Dawson S, Pinchbeck GL, Williams NJ, Radford AD, Jones PH. Pharmaceutical Prescription in Canine Acute Diarrhoea: A Longitudinal Electronic Health Record Analysis of First Opinion Veterinary Practices. Front Vet Sci 2019; 6:218. [PMID: 31334254 PMCID: PMC6615257 DOI: 10.3389/fvets.2019.00218] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/18/2019] [Indexed: 12/17/2022] Open
Abstract
Canine acute diarrhoea is frequently observed in first opinion practice, though little is known about commonly used diagnostic or therapeutic management plans, including use of antimicrobials. This retrospective observational study utilised electronic health records augmented with practitioner-completed questionnaires from 3,189 cases (3,159 dogs) collected from 179 volunteer veterinary practices between April 2014 and January 2017. We used multivariable analysis to explore factors potentially associated with pharmaceutical agent prescription, and resolution of clinical signs by 10 days post-initial presentation. Use of bacteriological and/or parasitological diagnostic tests were uncommon (3.2% of cases, 95% confidence interval, CI, 2.4–4.0), though systemic antimicrobials were the most commonly prescribed pharmaceutical agents (49.7% of cases, 95% CI 46.1–53.2). Such prescription was associated with haemorrhagic diarrhoea (odds ratio, OR, 4.1; 95% CI 3.4–5.0), body temperature in excess of 39.0°C, or moderate/severe cases (OR 1.3, 95% CI 1.1–1.7). Gastrointestinal agents (e.g., antacids) were prescribed to 37.7% of cases (95% CI 35.4–39.9), and were most frequently prescribed to vomiting dogs regardless of presence (OR 46.4, 95% CI 19.4–110.8) or absence of blood (OR 17.1, 95% CI 13.4–21.9). Endoparasiticides/endectocides were prescribed to 7.8% of cases (95% CI 6.8–9.0), such prescription being less frequent for moderate/severe cases (OR 0.5, 95% CI 0.4–0.7), though more frequent when weight loss was recorded (OR 3.4, 95% CI 1.3–9.0). Gastrointestinal nutraceuticals (e.g., probiotics) were dispensed to 60.8% of cases (95% CI 57.1–64.6), these cases less frequently presenting with moderate/severe clinical signs (OR 0.6, 95% CI 0.5–0.8). Nearly a quarter of cases were judged lost to follow-up (n=754). Insured (OR 0.7, 95% CI 0.5–0.9); neutered (OR 0.4, 95% CI 0.3–0.5), or vaccinated dogs (OR 0.3, 95% CI 0.3–0.4) were less commonly lost to follow-up. Of remaining dogs, clinical signs were deemed resolved in 95.4% of cases (95% CI 94.6–96.2). Provision of dietary modification advice and gastrointestinal nutraceuticals alone were positively associated with resolution (OR 2.8, 95% CI 1.3–6.1); no such associations were found for pharmaceutical agents, including antimicrobials. Hence, this study supports the view that antimicrobials are largely unnecessary for acute diarrhoea cases; this being of particular importance when considering the global threat posed by antimicrobial resistance.
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Affiliation(s)
- David A Singleton
- Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - P J M Noble
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | | | - Susan Dawson
- Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Gina L Pinchbeck
- Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Nicola J Williams
- Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Alan D Radford
- Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Philip H Jones
- Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
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Abstract
ABSTRACT
Non-typhoidal
Salmonella
is the most common foodborne bacterial pathogen in most countries. It is widely present in food animal species, and therefore blocking its transmission through the food supply is a prominent focus of food safety activities worldwide. Antibiotic resistance in non-typhoidal
Salmonella
arises in large part because of antibiotic use in animal husbandry. Tracking resistance in
Salmonella
is required to design targeted interventions to contain or diminish resistance and refine use practices in production. Many countries have established systems to monitor antibiotic resistance in
Salmonella
and other bacteria, the earliest ones appearing the Europe and the US. In this chapter, we compare recent
Salmonella
antibiotic susceptibility data from Europe and the US. In addition, we summarize the state of known resistance genes that have been identified in the genus. The advent of routine whole genome sequencing has made it possible to conduct genomic surveillance of resistance based on DNA sequences alone. This points to a new model of surveillance in the future that will provide more definitive information on the sources of resistant
Salmonella
, the specific types of resistance genes involved, and information on how resistance spreads.
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Welsh CE, Duz M, Parkin TDH, Marshall JF. Disease and pharmacologic risk factors for first and subsequent episodes of equine laminitis: A cohort study of free-text electronic medical records. Prev Vet Med 2016; 136:11-18. [PMID: 28010903 DOI: 10.1016/j.prevetmed.2016.11.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 01/03/2023]
Abstract
Electronic medical records from first opinion equine veterinary practice may represent a unique resource for epidemiologic research. The appropriateness of this resource for risk factor analyses was explored as part of an investigation into clinical and pharmacologic risk factors for laminitis. Amalgamated medical records from seven UK practices were subjected to text mining to identify laminitis episodes, systemic or intra-synovial corticosteroid prescription, diseases known to affect laminitis risk and clinical signs or syndromes likely to lead to corticosteroid use. Cox proportional hazard models and Prentice, Williams, Peterson models for repeated events were used to estimate associations with time to first, or subsequent laminitis episodes, respectively. Over seventy percent of horses that were diagnosed with laminitis suffered at least one recurrence. Risk factors for first and subsequent laminitis episodes were found to vary. Corticosteroid use (prednisolone only) was only significantly associated with subsequent, and not initial laminitis episodes. Electronic medical record use for such analyses is plausible and offers important advantages over more traditional data sources. It does, however, pose challenges and limitations that must be taken into account, and requires a conceptual change to disease diagnosis which should be considered carefully.
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Affiliation(s)
- Claire E Welsh
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK.
| | - Marco Duz
- School of Veterinary Medicine and Science, University of Nottingham, UK
| | - Timothy D H Parkin
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK
| | - John F Marshall
- Equine Clinical Sciences Division, Weipers Centre Equine Hospital, School of Veterinary Medicine, University of Glasgow, UK
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Welsh CE, Parkin TDH, Marshall JF. Use of large-scale veterinary data for the investigation of antimicrobial prescribing practices in equine medicine. Equine Vet J 2016; 49:425-432. [DOI: 10.1111/evj.12638] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 08/25/2016] [Indexed: 12/20/2022]
Affiliation(s)
- C. E. Welsh
- Equine Clinical Sciences Division; School of Veterinary Medicine; University of Glasgow; UK
| | - T. D. H. Parkin
- Equine Clinical Sciences Division; School of Veterinary Medicine; University of Glasgow; UK
| | - J. F. Marshall
- Equine Clinical Sciences Division; School of Veterinary Medicine; University of Glasgow; UK
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ANHOLT RM, BEREZOWSKI J, ROBERTSON C, STEPHEN C. Spatial-temporal clustering of companion animal enteric syndrome: detection and investigation through the use of electronic medical records from participating private practices. Epidemiol Infect 2015; 143:2547-58. [PMID: 25543461 PMCID: PMC9151043 DOI: 10.1017/s0950268814003574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/28/2014] [Accepted: 11/28/2014] [Indexed: 11/05/2022] Open
Abstract
There is interest in the potential of companion animal surveillance to provide data to improve pet health and to provide early warning of environmental hazards to people. We implemented a companion animal surveillance system in Calgary, Alberta and the surrounding communities. Informatics technologies automatically extracted electronic medical records from participating veterinary practices and identified cases of enteric syndrome in the warehoused records. The data were analysed using time-series analyses and a retrospective space-time permutation scan statistic. We identified a seasonal pattern of reports of occurrences of enteric syndromes in companion animals and four statistically significant clusters of enteric syndrome cases. The cases within each cluster were examined and information about the animals involved (species, age, sex), their vaccination history, possible exposure or risk behaviour history, information about disease severity, and the aetiological diagnosis was collected. We then assessed whether the cases within the cluster were unusual and if they represented an animal or public health threat. There was often insufficient information recorded in the medical record to characterize the clusters by aetiology or exposures. Space-time analysis of companion animal enteric syndrome cases found evidence of clustering. Collection of more epidemiologically relevant data would enhance the utility of practice-based companion animal surveillance.
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Affiliation(s)
- R. M. ANHOLT
- Faculty of Veterinary Medicine, Department of Ecosystem and Public Health, University of Calgary, AB, Canada
| | - J. BEREZOWSKI
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - C. ROBERTSON
- Department of Geography and Environmental Studies, Wilfrid Laurier University, Waterloo, ON, Canada
| | - C. STEPHEN
- Faculty of Veterinary Medicine, Department of Ecosystem and Public Health, University of Calgary, AB, Canada
- Centre for Coastal Health, Nanaimo, BC, Canada
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