A mathematical, classical stratification modeling approach to disentangling the impact of weather on infectious diseases: A case study using spatio-temporally disaggregated Campylobacter surveillance data for England and Wales.

Disentangling the impact of the weather on transmission of infectious diseases is crucial for health protection, preparedness and prevention. Because weather factors are co-incidental and partly correlated, we have used geography to separate out the impact of individual weather parameters on other seasonal variables using campylobacteriosis as a case study. Campylobacter infections are found worldwide and are the most common bacterial food-borne disease in developed countries, where they exhibit consistent but country specific seasonality. We developed a novel conditional incidence method, based on classical stratification, exploiting the long term, high-resolution, linkage of approximately one-million campylobacteriosis cases over 20 years in England and Wales with local meteorological datasets from diagnostic laboratory locations. The predicted incidence of campylobacteriosis increased by 1 case per million people for every 5° (Celsius) increase in temperature within the range of 8°-15°. Limited association was observed outside that range. There were strong associations with day-length. Cases tended to increase with relative humidity in the region of 75-80%, while the associations with rainfall and wind-speed were weaker. The approach is able to examine multiple factors and model how complex trends arise, e.g. the consistent steep increase in campylobacteriosis in England and Wales in May-June and its spatial variability. This transparent and straightforward approach leads to accurate predictions without relying on regression models and/or postulating specific parameterisations. A key output of the analysis is a thoroughly phenomenological description of the incidence of the disease conditional on specific local weather factors. The study can be crucially important to infer the elusive mechanism of transmission of campylobacteriosis; for instance, by simulating the conditional incidence for a postulated mechanism and compare it with the phenomenological patterns as benchmark. The findings challenge the assumption, commonly made in statistical models, that the transformed mean rate of infection for diseases like campylobacteriosis is a mere additive and combination of the environmental variables.

Barriers to vaccine use in small ruminants and poultry in Tanzania.

Vaccination is an important disease prevention and control measure; however, vaccine adoption by livestock farmers in Tanzania is still low. This cross-sectional study examined the challenges to vaccine use faced by livestock owners and animal health professionals (AHPs) in Tanzania. A questionnaire was administered to 216 households that kept small ruminants and poultry and 19 AHPs' data were collected electronically via the survey platform Qualtrics, and descriptive statistics were performed. Households with poultry reported vaccinating mostly against Newcastle disease (91.7%), fowl pox (48.1%) and Gumboro disease (37.0%), whilst households with small ruminants reported contagious caprine pleuropneumonia (62.2%), sheep and goat pox (17.1%), foot-and-mouth disease (7.3%) and peste des petits ruminants (7.3%). The households' decision to vaccinate was mostly influenced by knowledge of diseases (82.4%), disease history on the farm (69.4%) and vaccine price (63.4%). Most households (54.6%) experienced challenges when purchasing vaccines, including high vaccine cost (78.0%), long distance from vaccine source (61.0%) and vaccine unavailability (21.2%). The findings suggest that improving the knowledge of livestock owners regarding the priority diseases and the benefits of vaccination, establishing more vaccine suppliers, improving vaccine distribution and access and training AHPs and households on appropriate vaccine storage and handling are necessary to improve vaccine adoption and ensure vaccine quality and effectiveness.

Epidemiology of Peste des Petits Ruminants in Nigeria: A Review.

Peste des petits ruminants (PPR) is a major constraint to the productivity of small ruminants in Nigeria. Understanding of the current epidemiological status of PPR is crucial to its effective control. A review of the epidemiology of PPR in Nigeria was performed and research gaps were identified. Thirty-seven eligible articles were reviewed: these presented information from 30 of the 36 states of Nigeria. Most studies focused on goats and/or sheep (n = 33) but camels (n = 4), cattle (n = 1) and wild ruminants (n = 2) were also considered. Fourteen (37.8%) of the articles reported seroprevalence in small ruminants, which varied from 0.0% to 77.5% where more than 10 animals were sampled. Molecular characterization and phylogenetic analysis were performed in 6 studies, with lineages II and IV, detected in sheep and goats. In one study in small ruminants, sequences clustering into lineage I showed a similarity to the vaccine strain, Nigeria 75/1, based on phylogenetic analysis of F gene sequences. However, if the preferred method of sequencing the N gene had been performed, this isolate would have been grouped into lineage II. According to N gene phylogenetic analysis in the other studies, sequences were identified that clustered with clade II-NigA, II-NigB (closely related to the Nigeria 75/1 vaccine strain), and others which were well separated, suggesting a high diversity of PPRV in Nigeria. Five articles reported the detection of lineage IV in 22/36 states, with IV-NigA and IV-NigB detected, highlighting its widespread distribution in Nigeria. Risk factors for PPRV seropositivity were reported in 10/37 (27.0%) articles, with a higher seroprevalence observed in female animals, although differing results were observed when considering species and age separately. There were inconsistencies in study design and data reporting between studies which precluded conduct of a meta-analysis. Nevertheless, several research gaps were identified including the need to investigate the low uptake of PPRV vaccine, and the economic benefits of PPR control measures to small ruminant farmers. Such data will inform PPR control strategies in Nigeria and subsequently contribute to the global 2030 PPR eradication strategy.

Training needs assessment of veterinary practitioners in Ethiopia.

Pastoral and agro-pastoral farming are extensively practised in Ethiopia, and the main livestock kept are cattle, goats, sheep, poultry, and camels. The livestock sector is faced with complex challenges including limited availability of well-trained and skilled animal health professionals. The objective of this study was to identify and prioritise areas for training with the goal of providing evidence to guide strategies to improve the skills, delivery, and governance of veterinary services across Ethiopia. A cross-sectional survey was developed and administered electronically to veterinary professionals in Ethiopia using the Qualtrics platform. Data were collected on select parameters including demographics, diseases of economic significance, diagnosis, disease prevention, biosecurity, disease control, treatment, epidemiology, One Health, disease reporting, and the participants' opinions about training. The survey data was downloaded in Microsoft Excel and descriptive statistics performed. A total of 234 veterinary professionals completed the survey. Most participants were male (89.7%) and aged between 26 and 35 years (81.2%). Of the total respondents, 56.4% worked in government and 8.5% in private practice. Most participants perceived training on laboratory diagnostic testing, disease prevention, antimicrobial resistance, antibiotic sensitivity testing, basic epidemiology, and clinical procedures, as most beneficial. In addition, most respondents would like to receive training on diseases affecting cattle, poultry, and small ruminants. The findings from this study provide baseline information on priority training areas for veterinary professionals and could potentially contribute to national efforts to develop and implement a continuing professional development programme in the veterinary domain, in view of improving veterinary service delivery.

Continuing Education of Animal Health Professionals in Uganda: A Training Needs Assessment.

In Uganda, delivery of veterinary services is vital to animal health and productivity, and is heavily dependent on well-trained and skilled animal health professionals. The purpose of this study was to identify and prioritize areas for refresher training and continuous professional development of animal health professionals (veterinarians and veterinary paraprofessionals), with the overarching aim of improving veterinary service delivery in Uganda. A survey was administered electronically to 311 animal health professionals during the period November 14-30, 2019. Data were collected on relevant parameters including demographics, knowledge on preventive medicine, diagnostics, disease control and treatment, epidemiology, and One Health, as well as participants' opinions on training priorities, challenges faced, and constraints to veterinary service delivery. Most respondents were veterinarians 26-35 years old, were male, and worked in clinical practice. Lowest perceived knowledge was reported on subjects relating to laboratory diagnostics, antimicrobial resistance (AMR), and nutrition. Training topics considered to be of most benefit to respondents included laboratory diagnostics, treatment of common livestock diseases, AMR, and practical clinical skills in reproductive and preventive medicine. Participants preferred to receive training in the form of practical workshops, in-practice training, and external training. This study highlights the need to prioritize training in practical clinical skills, laboratory diagnostics, and AMR. Wet labs and hands-on practical clinical and laboratory skills should be incorporated to enhance training. Provision of targeted and successful trainings will be dependent on the allocation of adequate resources and support by relevant public and private stakeholders across the veterinary sector.

Baseline Assessment of Poultry Production, Pharmaceutical Product Use, and Related Challenges on Commercial Poultry Flocks in Kano and Oyo States of Nigeria.

Poultry production is a major component of the livestock sector in Nigeria and continues to expand rapidly; however, it is still constrained by low productivity. A farm survey was conducted to provide a baseline assessment of poultry production (products generated, farm costs, and revenue), pharmaceutical use, and related challenges faced by farmers on 44 commercial poultry farms in Oyo and Kano states of Nigeria. Live spent layers, eggs, and used beddings were the most frequently sold products for revenue. Antibiotic products were widely used, the most reported were Doxygen, Tylosin, and Conflox. Overall, 40% of farms used feed additives (including toxin binders, minerals, and vitamins) and 12% used coccidiostats. Access to pharmaceutical products was a key challenge and appeared to disproportionally affect farmers in the northern part (Kano) of Nigeria. Other challenges included perceived antibiotic ineffectiveness, high cost of drugs, and long distances to pharmaceutical suppliers. Challenges related to vaccine use were unavailability, distance to the supplier, and health issues interfering with the vaccination schedule. Study findings highlight the need for improved access to veterinary pharmaceuticals, particularly in the northern states. Further investigations into the causes of antibiotic ineffectiveness and strategies for distribution of high-quality, effective pharmaceuticals are also necessary.

A Survey of Priority Livestock Diseases and Laboratory Diagnostic Needs of Animal Health Professionals and Farmers in Uganda.

Background: Despite the investments made in veterinary diagnostic laboratory service delivery in Uganda, the scope and level of utilization remains low. This study aimed to determine the priority livestock diseases for which farmers and animal health professionals require veterinary diagnostic laboratory services, document the perceptions and opinions of key stakeholders on veterinary diagnostic laboratory services, and determine the factors that influence the delivery and utilization of animal disease diagnostic services in Uganda. Methods: A qualitative study approach involving a survey and key informant interviews was used to collect relevant data from four stakeholder groups: animal health workers, laboratory technologists and technicians, farmers, and key informants. The survey data were exported to excel, and descriptive statistics performed. The key informant interview recordings were transcribed, and thematic analysis performed. Results: The most reported diseases and conditions for which diagnostic services were needed were hemoparasites (including East Coast fever, anaplasmosis, babesiosis, and trypanosomosis), viral (including Foot and mouth disease, lumpy skin disease, rift valley fever, and papillomatosis), bacteria (including brucellosis, colibacillosis, anthrax, leptospirosis, and paratuberculosis) and protozoa diseases (coccidiosis), endoparasites (helminths), and mastitis. The most common diagnostic laboratory tests requested by clients, but laboratories were unable to provide included: rapid tests for contagious bovine pleuropneumonia, Foot and mouth disease, Newcastle disease, acaricide analysis, culture and antimicrobial sensitivity test, serology, and complete blood count. The most frequently reported challenges to providing diagnostic laboratory services were poor or lack of relevant equipment, insufficient or lack of supplies and reagents, high cost of reagents, inadequate or lack of laboratory staff to perform tests, and inadequate training of laboratory staff. Conclusions: This study highlighted the need to improve provision of laboratory diagnostic services to meet the prioritized diagnostic needs of farmers and animal health professionals. Increased intersectoral engagement and funding support from the private, industry, and government sectors is necessary to help address the observed challenges to provision of diagnostic laboratory services, including equipping of the laboratories, provision of supplies, and hiring and training of laboratory staff. Finally, the findings also suggest that the education of farmers and animal health workers on the value and benefits of laboratory diagnostic services may contribute to increase in sample submission and subsequent demand for diagnostic laboratory services.

Construction of a Conceptual Framework for Assessment of Health-Related Quality of Life in Dogs With Osteoarthritis.

An owner's ability to detect changes in the behavior of a dog afflicted with osteoarthritis (OA) may be a barrier to presentation, clinical diagnosis and initiation of treatment. Management of OA also relies upon an owner's ability to accurately monitor improvement following a trial period of pain relief. The changes in behavior that are associated with the onset and relief of pain from OA can be assessed to determine the dog's health-related quality of life (HRQOL). HRQOL assessments are widely used in human medicine and if developed correctly can be used in the monitoring of disease and in clinical trials. This study followed established guidelines to construct a conceptual framework of indicators of HRQOL in dogs with OA. This generated items that can be used to develop a HRQOL assessment tool specific to dogs with OA. A systematic review was conducted using Web of Science, PubMed and Scopus with search terms related to indicators of HRQOL in dogs with osteoarthritis. Eligibility and quality assessment criteria were applied. Data were extracted from eligible studies using a comprehensive data charting table. Resulting domains and items were assessed at a half-day workshop attended by experts in canine osteoarthritis and quality of life. Domains and their interactions were finalized and a visual representation of the conceptual framework was produced. A total of 1,264 unique articles were generated in the database searches and assessed for inclusion. Of these, 21 progressed to data extraction. After combining synonyms, 47 unique items were categorized across six domains. Review of the six domains by the expert panel resulted in their reduction to four: physical appearance, capability, behavior, and mood. All four categories were deemed to be influenced by pain from osteoarthritis. Capability, mood, and behavior were all hypothesized to impact on each other while physical appearance was impacted by, but did not impact upon, the other domains. The framework has potential application to inform the development of valid and reliable instruments to operationalize measurement of HRQOL in canine OA for use in general veterinary practice to guide OA management decisions and in clinical studies to evaluate treatment outcomes.

Evaluating Disease Threats to Sustainable Poultry Production in Africa: Newcastle Disease, Infectious Bursal Disease, and Avian Infectious Bronchitis in Commercial Poultry Flocks in Kano and Oyo States, Nigeria.

The growth of the poultry industry in Nigeria is constrained by major poultry diseases, despite the implementation of vaccination programs. This study aimed to assess the level of protection against Newcastle disease (ND), infectious bursal disease (IBD), and avian infectious bronchitis (IB) afforded by current vaccination schedules and characterize the circulating virus strains in commercial poultry flocks in Nigeria. A cross-sectional study was conducted on 44 commercial poultry farms in Oyo and Kano states of Nigeria. Serum and tissue samples and data on flock, clinical and vaccination records were collected on each farm. Farms were classified as being protected or not protected against ND, IBD and IB based on a defined criterion. Real-time reverse transcription polymerase chain reaction (rRT-PCR) testing was performed for each target virus on tissue samples and positive samples were sequenced. A total of 15/44 (34.1%), 35/44 (79.5%), and 1/44 (2.3%) farms were considered to be protected against ND, IBD, and IB, respectively, at the time of sampling. NDV RNA was detected on 7/44 (15.9%) farms and sequences obtained from 3/7 farms were characterized as the lentogenic strain. Infectious bursal disease virus (IBDV) RNA was detected on 16/44 (36.4%) farms tested; very virulent (vv) IBDV and non-virulent (nv) IBDV strains were both detected in 3/16 (18.8%) positive samples. Sequences of IBDV isolates were either clustered with a group of genotype 3 virulent IBDV strains or were related to vaccine strains MB and D78 strains. IBV RNA was detected on 36/44 (81.8%) farms, with variant02, Massachusetts, 4/91, and Q1 variants detected. Sequences of IBV isolates were either clustered with the vaccines strains Massachusetts M41 and H120 or were most closely related to the D274-like strains or a clade of sequences reported in Nigeria and Niger in 2006 and 2007. This study revealed that most study farms in Oyo and Kano states did not have adequate protective antibody titers against IBV and NDV and were therefore at risk of field challenge. Infectious bursal disease virus and IBV RNA were detected on farms with a history of vaccination suggesting potential vaccination failure, or that the vaccine strains used mismatch with the circulating strains and are therefore not protective.

Antibiotic use practices of veterinarians and para-veterinarians and the implications for antibiotic stewardship in Nigeria.

The aim of this study was to describe the antibiotic use practices of veterinarians and para-veterinarians in Nigeria. An online survey was distributed during November through December 2018 via email and phone to veterinarians and para-veterinarians to collect information on antibiotic use practices. Data were downloaded into Excel and descriptive statistics were presented and analysed. The survey was completed by 390 respondents. Almost all respondents (98.5%, 384/390) recommended the use of antibiotics to treat animal patients, and of these, 93.2% (358/384) were veterinarians and 6.8% (26/384) were para-veterinarians. Most respondents reported commonly recommending the use of oxytetracycline (82.6%, 317/384), tylosin (44.5%, 171/384) and gentamycin (43.8%, 168/384). A third (32.0%, 122/384) of respondents did not undertake antimicrobial susceptibility testing (AST) prior to antibiotic treatment. At least 60% of the respondents recommended the use of antibiotics for the treatment of non-bacterial pathogens, including viral, helminth and fungal pathogens. Over 55% (217/390) were not aware of government-issued guidelines on antibiotic use in animals, although of those aware, 69% (74/107) utilised the guidelines. Across all respondents, the majority believed legislation or regulation by government can influence the use of antibiotics by animal health professionals. The study highlights areas that can be targeted as part of intervention strategies to promote antimicrobial stewardship by animal health professionals in Nigeria, including the need for increased use of AST as a tool for supporting disease management, increased awareness of appropriate antibiotic use and greater dissemination of antibiotic use guidelines and enforcement of relevant regulation by government authorities.

A Review of the Current Status of Peste des Petits Ruminants Epidemiology in Small Ruminants in Tanzania.

Peste des petits ruminants (PPR) is a highly contagious viral disease of sheep and goats with high mortality. The disease is of considerable economic importance in countries such as Tanzania, where small ruminant products are important for sustainable livelihoods. This review assesses current knowledge regarding the epidemiology of PPRV in Tanzania, highlighting the challenges with respect to control and suggesting possible interventions. Thirty-three articles were identified after literature searches using Google Scholar and PubMed. Studies revealed that PPRV is endemic in sheep and goats in Tanzania, although seropositivity has also been reported in cattle, camels, buffalo, Grant's gazelle, wildebeest and impala, but with no clinical manifestation. Three lineages (lineage II to IV) of PPRV have been identified in Tanzania, implying at least two separate introductions of the virus. Diagnosis of PPR in Tanzania is mostly by observation of clinical signs and lesions at post mortem. Risk factors in Tanzania include age, sex, species, and close contact of animals from different farms/localities. Although there is an efficacious vaccine available for PPR, poor disease surveillance, low vaccine coverage, and uncontrolled animal movements have been the bane of control efforts for PPR in Tanzania. There is need for collaborative efforts to develop interventions to control and eradicate the disease. The establishment of a national reference laboratory for PPR, conduct of surveillance, the development of high-quality DIVA vaccines, as well as execution of a carefully planned national vaccination campaign may be key to the control and subsequent eradication of PPR in Tanzania and achieving the global goal of eradicating PPR by 2030.

Knowledge, Attitudes and Practices of Veterinarians Towards Antimicrobial Resistance and Stewardship in Nigeria.

Antimicrobial resistance (AMR) is a global health concern and the inappropriate use of antibiotics in animals and humans is considered a contributing factor. A cross-sectional survey to assess the knowledge, attitudes and practices of veterinarians regarding AMR and antimicrobial stewardship was conducted in Nigeria. A total of 241 respondents completed an online survey. Only 21% of respondents correctly defined the term antimicrobial stewardship and 59.8% were unaware of the guidelines provided by the Nigeria AMR National Action Plan. Over half (51%) of the respondents indicated that prophylactic antibiotic use was appropriate when farm biosecurity was poor. Only 20% of the respondents conducted antimicrobial susceptibility testing (AST) frequently, and the unavailability of veterinary laboratory services (82%) and the owner's inability to pay (72%) were reported as key barriers to conducting AST. The study findings suggest strategies focusing on the following areas may be useful in improving appropriate antibiotic use and antimicrobial stewardship among veterinarians in Nigeria: increased awareness of responsible antimicrobial use among practicing and newly graduated veterinarians, increased dissemination of regularly updated antibiotic use guidelines, increased understanding of the role of good biosecurity and vaccination practices in disease prevention, and increased provision of laboratory services and AST at affordable costs.

Small Ruminant Production in Tanzania, Uganda, and Ethiopia: A Systematic Review of Constraints and Potential Solutions.

Sheep and goats are an important commodity for smallholder farmers across East Africa, but severe limitations remain in small ruminant production. This review aimed to identify specific constraints to small ruminant production and identify practical and sustainable solutions. From 54 eligible articles, most were focused in Ethiopia (n = 44) with only 6 studies performed in Tanzania and 4 in Uganda. The most frequently identified constraint in Ethiopia and Tanzania was disease (n = 28 and n = 3, respectively), and in Uganda, it was the lack of access to veterinary services (n = 4). Additionally, access to good breeding stock, lack of animal records, and an established marketing chain were also mentioned in all the three countries. Ectoparasites, gastrointestinal parasites, orf, and sheep/goat pox were the most frequently mentioned disease challenges causing productivity losses. Many articles provided potential solutions as suggested by farmers, including improved access to veterinary services and medicines, improved record keeping, and access to good breeding stock. Farmers highlighted the value of community-based participatory development plans to increase education on disease control, land management, and husbandry. This review also highlighted knowledge gaps, the need for further research, particularly in Tanzania and Uganda, and the importance of addressing multiple challenges holistically due to the links between constraints.

Unbiased assessment of disease surveillance utilities: A prospect theory application.

OBJECTIVES: We contribute a new methodological approach to the ongoing efforts towards evaluating public health surveillance. Specifically, we apply a descriptive framework, grounded in prospect theory (PT), for the evaluation of decisions on disease surveillance deployment. We focus on two attributes of any surveillance system: timeliness, and false positive rate (FPR). METHODS: In a sample of 69 health professionals from a number of health related networks polled online, we elicited PT preferences, specifically respondents' attitudes towards gains, losses and probabilities (i.e., if they overweight or underweight extreme probabilities) by means of a series of lotteries for either timeliness or FPR. Moreover, we estimated willingness to pay (WTP) for improvements in the two surveillance attributes. For contextualization, we apply our framework to rabies surveillance. RESULTS: Our data reveal considerable probability weighting, both for gains and losses. In other words, respondents underestimate their chances of getting a good outcome in uncertain situations, and they overestimate their chances of bad outcomes. Moreover, there is convex utility for losses and loss aversion, that is, losses loom larger than gains of the same absolute magnitude to the respondents. We find no differences between the estimated parameters for timeliness and FPR. The median WTP is $7,250 per day gained in detection time and $30 per 1/10,000 reduction in FPR. CONCLUSION: Our results indicate that the biases described by PT are present among public health professionals, which highlights the need to incorporate a PT framework when eliciting their preferences for surveillance systems.

Investigating the Association Between the Caecal Microbiomes of Broilers and Campylobacter Burden.

One of the major transmission routes for the foodborne bacterial pathogen Campylobacter is undercooked poultry meat, contaminated from intestinal contents during processing. In broilers, Campylobacter can grow to very high densities in the caeca, and is often considered to be a commensal or an opportunistic pathogen in poultry. Reduction of caecal loads of Campylobacter may assist in lowering incidence rates of Campylobacter food poisoning. To achieve this, there needs to be a better understanding of the dynamics of Campylobacter colonization in its natural niche, and the effect of the local microbiome on colonization. Previous studies have shown that the microbiome differed between Campylobacter colonized and non-colonized chicken intestinal samples. To characterize the microbiome of Campylobacter-colonized broilers, caecal samples of 100 randomly selected birds from four farms were analyzed using amplified 16S rRNA gene sequences. Bacterial taxonomic analysis indicated that inter-farm variation was greater than intra-farm variation. The two most common bacterial groups were Bacteroidetes and Firmicutes which were present in all samples and constituted 29.7-63.5 and 30.2-59.8% of the bacteria present, respectively. Campylobacter was cultured from all samples, ranging from 2 to 9 log10 CFU g-1. There was no clear link between Campylobacter counts and Firmicutes, Bacteroidetes, or Tenericutes levels in the 16S rRNA operational taxonomic unit (OTU)-based analysis of the caecal microbiome, but samples with high Campylobacter counts (>9 log CFU g-1) contained increased levels of Enterobacteriaceae. A decrease in Lactobacillus abundance in chicken caeca was also associated with high Campylobacter loads. The reported associations with Lactobacillus and Enterobacteriaceae match changes in the intestinal microbiome of chickens and mice previously reported for Campylobacter infection, and raises the question about temporality and causation; as to whether increases in Campylobacter loads create conditions adverse to Lactobacilli and/or beneficial to Enterobacteriaceae, or that changes in Lactobacilli and Enterobacteriaceae levels created conditions beneficial for Campylobacter colonization. If these changes can be controlled, this may open opportunities for modulation of chicken microbiota to reduce Campylobacter levels for improved food safety.

Methodology and preliminary results of a systematic literature review of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis.

A systematic review was conducted to identify studies with data for statistical meta-analyses of sensitivity (Se) and specificity (Sp) of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis (bTB) in cattle. Members of a working group (WG) developed and tested search criteria and developed a standardised two-stage review process, to identify primary studies with numerator and denominator data for test performance and an agreed range of covariate data. No limits were applied to year, language, region or type of test in initial searches of electronic databases. In stage 1, titles and available abstracts were reviewed. References that complied with stage 1 selection criteria were reviewed in entirety and agreed data were extracted from references that complied with stage 2 selection criteria. At stage 1, 9782 references were reviewed and 261 (2.6%) passed through to stage 2 where 215 English language references were each randomly allocated to two of 18 WG reviewers and 46 references in other languages were allocated to native speakers. Agreement regarding eligibility between reviewers of the same reference at stage 2 was moderate (Kappa statistic = 0.51) and a resolution procedure was conducted. Only 119 references (published 1934-2009) were identified with eligible performance estimates for one or more of 14 different diagnostic test types; despite a comprehensive search strategy and the global impact of bTB. Searches of electronic databases for diagnostic test performance data were found to be nonspecific with regard to identifying references with diagnostic test Se or Sp data. Guidelines for the content of abstracts to research papers reporting diagnostic test performance are presented. The results of meta-analyses of the sensitivity and specificity of the tests, and of an evaluation of the methodological quality of the source references, are presented in accompanying papers (Nuñez-Garcia et al., 2017; Downs et al., 2017).

Meta-analyses of the sensitivity and specificity of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis in the UK and Ireland.

Bovine Tuberculosis (bTB) in cattle is a global health problem and eradication of the disease requires accurate estimates of diagnostic test performance to optimize their efficiency. The objective of this study was, through statistical meta-analyses, to obtain estimates of sensitivity (Se) and specificity (Sp), for 14 different ante-mortem and post-mortem diagnostic tests for bTB in cattle. Using data from a systematic review of the scientific literature (published 1934-2009) diagnostic Se and Sp were estimated using Bayesian logistic regression models adjusting for confounding factors. Random effect terms were used to account for unexplained heterogeneity. Parameters in the models were implemented using Markov Chain Monte Carlo (MCMC), and posterior distributions for the diagnostic parameters with adjustment for covariates (confounding factors) were obtained using the inverse logit function. Estimates for Se and/or Sp of the tuberculin skin tests and the IFN-γ blood test were compared with estimates published 2010-2015. Median Se for the single intradermal comparative cervical tuberculin skin (SICCT) test (standard interpretation) was 0.50 and Bayesian credible intervals (CrI) were wide (95% CrI 0.26, 0.78). Median Sp for the SICCT test was 1.00 (95% CrI 0.99, 1.00). Estimates for the IFN-γ blood test Bovine Purified Protein Derivative (PPD)-Avian PPD and Early Secreted Antigen target 6 and Culture Filtrate Protein 10 (ESAT-6/CFP10) ESAT6/CFP10 were 0.67 (95% CrI 0.49, 0.82) and 0.78 (95% CrI 0.60, 0.90) respectively for Se, and 0.98 (95% CrI 0.96, 0.99) and 0.99 (95% CrI 0.99, 1.00) for Sp. The study provides an overview of the accuracy of a range of contemporary diagnostic tests for bTB in cattle. Better understanding of diagnostic test performance is essential for the design of effective control strategies and their evaluation.

Evaluation of the methodological quality of studies of the performance of diagnostic tests for bovine tuberculosis using QUADAS.

There has been little assessment of the methodological quality of studies measuring the performance (sensitivity and/or specificity) of diagnostic tests for animal diseases. In a systematic review, 190 studies of tests for bovine tuberculosis (bTB) in cattle (published 1934-2009) were assessed by at least one of 18 reviewers using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) checklist adapted for animal disease tests. VETQUADAS (VQ) included items measuring clarity in reporting (n = 3), internal validity (n = 9) and external validity (n = 2). A similar pattern for compliance was observed in studies of different diagnostic test types. Compliance significantly improved with year of publication for all items measuring clarity in reporting and external validity but only improved in four of the nine items measuring internal validity (p < 0.05). 107 references, of which 83 had performance data eligible for inclusion in a meta-analysis were reviewed by two reviewers. In these references, agreement between reviewers' responses was 71% for compliance, 32% for unsure and 29% for non-compliance. Mean compliance with reporting items was 2, 5.2 for internal validity and 1.5 for external validity. The index test result was described in sufficient detail in 80.1% of studies and was interpreted without knowledge of the reference standard test result in only 33.1%. Loss to follow-up was adequately explained in only 31.1% of studies. The prevalence of deficiencies observed may be due to inadequate reporting but may also reflect lack of attention to methodological issues that could bias the results of diagnostic test performance estimates. QUADAS was a useful tool for assessing and comparing the quality of studies measuring the performance of diagnostic tests but might be improved further by including explicit assessment of population sampling strategy.

Changes in perceptions and motivators that influence the implementation of on-farm Salmonella control measures by pig farmers in England.

This study presents British farmers' perception of, and barriers to, implementing Salmonella control on pig farms. Four farms that had implemented interventions and their 33 close contacts (known to the intervention farmers) took part in interviews before (phase 1) and after (phase 2) intervention trials to assess the difference in perception over time. Their results were compared against those from nine randomly selected control farms. The hypothesis was that farms implementing interventions whether or not successful, would influence their close contacts' opinion over time. Based on a 'pathway to disease control' model, three intrinsic factors known to influence motivation - attitudes, social norms and self-efficacy - were evaluated. Farmers mentioned that successful interventions on a farm would attract their attention. The use of an appropriate communication strategy is therefore recommended to stimulate farmers' intent to implement control measures. Both before and after the intervention trials, all farmers had a positive attitude towards Salmonella control and felt that their peers and authorities were supportive of controlling Salmonella on farms. In phase 2, however, farmers were more likely to want to share the burden of control with other stakeholders along the food chain and their belief in self-efficacy had weakened. Whilst social norms were not associated with an intention to take action on control, a positive attitude towards Salmonella control and a belief in self-efficacy were more likely to result in an intent to control. In phase 2, farmers with an intent to implement an intervention appeared to have a greater, but not significant positive belief in self-efficacy (p=0.108). This study confirmed that farmers recognised their responsibility for controlling Salmonella in pork - even though their confidence in their ability to control Salmonella decreased over time - and believed that responsibility should be shared with the rest of the production chain. It showed that farmers trusted their veterinarian as a source of advice to guide them during the process of implementing change, though an increase in farms' Salmonella seroprevalence score (Zoonosis National Control Programme (ZNCP) score) especially for those with a low ZNCP score was also likely to influence their behaviour. Getting concrete feedback from customers or a tangible benefit from their action was a strong incentive especially for farms with a ZNCP score higher than 50%. The study also revealed a need to validate which measures are effective as farmers did not perceive that the current advised interventions were worth the additional effort.