High discrimination of Mycobacterium bovis isolates in Brazilian herds by spoligotyping.

Bovine tuberculosis is an infectious disease caused by Mycobacterium bovis (M. bovis), that leads to economic losses in infected herds and it is also considered an important zoonosis. The molecular typing methods of M. bovis isolates are fundamental for the bovine tuberculosis surveillance system, and spoligotyping is the standard genotyping technique for this species. Thus, the aim of the present study is to analyze the spatial and cluster distribution of M. bovis strains from several regions of Brazil through molecular typing. Spoligotyping technique was applied on 422 isolates identified as M. bovis, and Ripley's K function was used to perform the spatial and cluster analysis of each identified profile. Forty-three (43) different profiles were identified and spoligotype SB0121 was the most frequent and showed a uniform pattern in the spatial distribution while spoligotypes SB0295, SB1380 and SB1050 formed clusters. In addition, three novel spoligotype profiles (SB2361, SB2362, SB2364) were identified in different herds. In this perspective, it is believed that molecular identification and typing can significantly improve the performance of surveillance systems for bovine tuberculosis in Brazil.

Institutional strategies as a mechanism to rationalize the negative effects of the judicialization of access to medicine in Brazil.

BACKGROUND: Recently, the Executive Branch and Judiciary in Brazil increased spending due to larger numbers of lawsuits that forced the State to provide health goods and services. This phenomenon, known as health judicialization, has created challenges and required the Executive Branch and Judiciary to create institutional strategies such as technical chambers and departments to reduce the social, economic and political distortions caused by this phenomenon. This study aims to evaluate the effects of two institutional strategies deployed by a Brazilian municipality in order to cope with the economic, social and political distortions caused by the phenomenon of health judicialization regarding access to medicines. METHODS: A longitudinal study was carried out in a capital in the Central-West Region of Brazil. A sample of 511 lawsuits was analyzed. The variables were placed into three groups: the sociodemographic characteristics and the plaintiffs' disease, the characteristics of the claimed medical products and the institutional strategies. To analyze the effect of the interventions on the total cost of the medicines in the lawsuits, bivariate and multivariate linear regressions with variance were performed. For the categorical outcomes, Poisson regressions were performed with robust variance, using a significance level of 5%. RESULTS: A reduction in the costs of medicines in the lawsuits and of the requests for medicines within the SUS formulary was verified after the deployment of the Department of Assessment of Nonstandardized Medicines (DAMNP) and the Technical Chamber of Health Assessment (CATS); an increase in processed prescriptions from the Brazilian Universal Health System was observed after the deployment of the CATS; and an increase in medicines outside the SUS formulary without a therapeutic alternative was verified after the CATS. CONCLUSION: The institutional strategies deployed were important tools to reduce the high costs of the medicines in the lawsuits. In addition, they represented a step forward for the State, provided a benefit to society and indicated a potential path for the health and justice systems of other countries that also face problems caused by the judicialization of health.

Development of a natural molluscicide prototype kit (MoluSchall) for the control of schistosomiasis mansoni transmission.

INTRODUCTION: In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. METHODS: E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. RESULTS: MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD100 as observed under laboratory conditions. CONCLUSIONS: MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.

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.

Development of a natural molluscicide prototype kit (MoluSchall) for the control of schistosomiasis mansoni transmission

Abstract INTRODUCTION In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are intermediate hosts of Schistosoma mansoni, the etiological agent of schistosomiasis mansoni. Molluscicide use is recommended by the WHO for controlling the transmission of this parasite. Euphorbia milii latex has shown promising results as an alternative molluscicide. Thus, a natural molluscicide prototype kit based on freeze-dried E. milii latex was developed and evaluated against Biomphalaria spp. METHODS E. milii latex was collected, processed, and lyophilized. Two diluents were defined for freeze-dried latex rehydration, and a prototype kit, called MoluSchall, was produced. A stability test was conducted using prototype kits stored at different temperatures, and a toxicity assay was performed using Danio rerio. Additionally, MoluSchall was tested against B. glabrata under semi-natural conditions according to defined conditions in the laboratory. RESULTS MoluSchall was lethal to three Brazilian snail species while exhibiting low toxicity to D. rerio. Regardless of storage temperature, MoluSchall was stable for 24 months and was effective against B. glabrata under semi-natural conditions, with the same LD100 as observed under laboratory conditions. CONCLUSIONS MoluSchall is a natural, effective, and inexpensive molluscicide with lower environmental toxicity than existing molluscicides. Its production offers a possible alternative strategy for controlling S. mansoni transmission.

A new methodology for royalties distribution of the Itaipu hydroelectric plant: The hydrographic basin as the unit of analysis.

Over the past few years, many sectors such as energy generation, industry, domestic supply, and agriculture have encountered serious environmental problems due to the lack of rainfall. Thus, the purpose of this paper is to review the current methodology of royalties distribution from Itaipu hydroelectric plant. In the proposed approach, two criteria were considered to establish the division of Itaipu royalties: (1) the relative percentage of the water flow in the generation of electricity and, (2) the relative percentage of the drop in the height of water. 62 hydroelectric plants were evaluated in this study. In 52 plants the water flow was the factor that most contributed to the generation of electricity. In 2013, 346 municipalities benefited the Itaipu royalties. With the proposed methodology, 1,327 municipalities will receive the resource, what would increase the revenue of each of these municipalities by, on average, US$ 87,436.91 per year. The methodology presented herein proposes a reduction in the environmental disparity that now exists in Brazil, through improvement to Government instruments and environmental policies. The distribution of royalties throughout the watershed can provide additional resources to support payment programs for environmental services at the state and municipality levels.

Indicações e tratamentos da laserterapia de baixa intensidade na odontologia: uma revisão sistemática da literatura / Indications and treatments of low level laser therapy in dentistry: a systematic review of the literature

Introdução: O laser de baixa intensidade (LLLT ­ Low Level Laser Therapy) possui efeitos anti-inflamatórios, analgésicos e trófico tecidual, podendo ser aplicado em uma grande variedade de condições clínicas na odontologia. Objetivo: este estudo teve como objetivo revisar as indicações e as possibilidades de tratamento de LLLT nas diversas especialidades odontológicas. Material e Métodos: Como estratégia de busca fez-se uma pesquisa bibliográfica nas bases de dados eletrônicas MEDLINE, BSV e SCIELO para identificar estudos relevantes de 2016 a 2018. Uma combinação das seguintes palavras-chaves foi utilizada: low level laser therapy e dentistry. Estas foram combinadas através do operador boleano "AND". Resultados: foram encontrados trinta e sete artigos com indicação de tratamento com laser de baixa intensidade na periodontia, ortodontia, cirurgia, odontopediatria, DTM, patologia, endodontia e dentística. Conclusão: LLLT é um tratamento seguro, sem efeitos colaterais que pode ser utilizado nas especialidades odontológicas como eficaz tratamento coadjuvante aos convencionais.

Introduction: The low level laser therapy (LLLT) has anti-inflammatory, analgesic and tissue-trophic effects, and can be applied in a wide variety of clinical conditions in dentistry. Objective: This study aimed to review indications and treatment possibilities with LLLT in the various dental specialties. Material and Methods: as a search strategy a bibliographic search was conducted in the electronic databases MEDLINE, BSV and SCIELO to identify relevant studies from 2016 to 2018. A combination of the following keywords was used: low level laser therapy and dentistry. These were combined through the Boolean operator "AND". Results: thirty seven articles were found with indication of low intensity laser treatment in periodontics, orthodontics, surgery, pediatric dentistry, TMD, pathology, endodontics and dentistry. Conclusion: LLLT is a safe treatment with no side effects that can be used in dental specialties as an effective adjunctive treatment to conventional ones.

Itaipu royalties: The role of the hydroelectric sector in water resource management.

For countries dependent on hydroelectricity, water scarcity poses a real risk. Hydroelectric plants are among the most vulnerable enterprises to climate change. Investing in the conservation of the hydrographic basin is a solution found by the hydropower sector. Given the importance of the Itaipu plant to the energy matrix of Brazil and Paraguay, the aim of this study is to review the current distribution of royalties from Itaipu, using the hydrographic basin as a of criterion of analysis. Approximately 98.73% of the Itaipu basin is in Brazil. The flow contributes 99% of the total electricity generated there, while the drop height of the water contributes only 1%. Under the current policy, royalties are shared equally between Brazil and Paraguay. In the proposed approach, each country would receive a percentage for their participation in the drop height and water flow in the output of the turbines, which are intrinsic factors for electricity generation. Thus, Brazil would receive 98.35% of the royalties and Paraguay, 1.65%. The inclusion of the hydrographic basin as a criterion for the distribution of royalties will promote more efficient water resource management, since the payment will be distributed throughout the basin of the plant. The methodology can be applied to hydroelectric projects worldwide.

Geotechnology and landscape ecology applied to the selection of potential forest fragments for seed harvesting.

The Atlantic Forest biome is recognized for its biodiversity and is one of the most threatened biomes on the planet, with forest fragmentation increasing due to uncontrolled land use, land occupation, and population growth. The most serious aspect of the forest fragmentation process is the edge effect and the loss of biodiversity. In this context, the aim of this study was to evaluate the dynamics of forest fragmentation and select potential forest fragments with a higher degree of conservation for seed harvesting in the Itapemirim river basin, Espírito Santo State, Brazil. Image classification techniques, forest landscape ecology, and multi-criteria analysis were used to evaluate the evolution of forest fragmentation to develop the landscape metric indexes, and to select potential forest fragments for seed harvesting for the years 1985 and 2013. According to the results, there was a reduction of 2.55% of the occupancy of the fragments in the basin between the years 1985 and 2013. For the years 1985 and 2013, forest fragment units 2 and 3 were spatialized with a high potential for seed harvesting, representing 6.99% and 16.01% of the total fragments, respectively. The methodology used in this study has the potential to be used to support decisions for the selection of potential fragments for seed harvesting because selecting fragments in different environments by their spatial attributes provides a greater degree of conservation, contributing to the protection and conscious management of the forests. The proposed methodology can be adapted to other areas and different biomes of the world.

Molecular Typing of Mycobacterium bovis from Cattle Reared in Midwest Brazil.

Mycobacterium bovis is the causative agent of bovine tuberculosis (BTB), the pathogen responsible for serious economic impact on the livestock sector. In order to obtain data on isolated M. bovis strains and assist in the control and eradication program for BTB, a cross sectional descriptive molecular epidemiology study in the Brazilian Midwest was conducted. Through spoligotyping and 24-loci MIRU-VNTR methods, 37 clinical isolates of M. bovis circulating in the region were analyzed, 10 isolated from the state of Mato Grosso, 12 from the state of Mato Grosso do Sul and 15 from the state of Goiás. The spoligotyping analysis identified 10 distinct M. bovis profiles (SB0121 n = 14, SB0295 n = 6, SB0140 n = 6, SB0881 n = 3, SB1144 n = 2, SB1145 n = 2, SB0134 n = 1, SB1050 n = 1, SB1055 n = 1, SB1136 n = 1) grouped in six clusters and four orphan patterns. The MIRU-VNTR 24-loci grouped the same isolates in six clusters and 22 unique orphan patterns, showing higher discriminatory power than spoligotyping. When associating the results of both techniques, the isolates were grouped in five clusters and 24 unique M. bovis profiles. Among the 24-loci MIRU-VNTR evaluated, two, ETR-A and QUB 11b loci, showed high discriminatory ability (h = ≥ 0.50), while MIRU 16, MIRU 27, ETR-B, ETR-C, Mtub21 and QUB 26 loci showed moderate ability (h = 0.33 or h = 0.49) and were the most effective in evaluating the genotypic similarities among the clinical M. bovis isolate samples. Herein, the 29 patterns found amongst the 37 isolates of M. bovis circulating in the Brazilian Midwest can be due to the animal movement between regions, municipalities and farms, thus causing the spread of various M. bovis strains in herds from Midwest Brazil.

Tuberculosis in water buffalo (Bubalus bubalis) in the Baixo Araguari Region, Amapá, Brazil / Tuberculose em búfalos (Bubalus bubalis) na região do Baixo Araguari, Amapá, Brazil

Water buffalo are of great economic importance in Brazilian Amazonia, which has the largest herd in Brazil. Bovine tuberculosis caused by Mycobacterium bovis is a zoonotic disease that results in severe losses to water buffalo production. Although the disease has already been described in the country, data on the occurrence and distribution of bovine tuberculosis in water buffalo in Brazil is very scarce. The aim of this study was to determine the frequency of bovine tuberculosis in water buffalo in the Baixo Araguari River region of Amapá, Brazil. Thirty herds, randomly selected from the 41 herds of water buffalo in the region, were sampled. From those herds, 212 randomly selected water buffalo were subjected to the comparative tuberculin skin test. The proportion of Baixo Araguari River region herds that were positive for bovine tuberculosis was 50.0% (95% CI 31.3% to 68.7%) and the proportion of animals that were positive was estimated to be 14.8% (95% CI 7.8% to 21.9%). Our results show that bovine tuberculosis is spread widely among water buffalo in the Baixo Araguari River region, which suggests that measures to control the disease should be undertaken in the region.(AU)

A criação de búfalos é de grande importância econômica na Região Amazônica, que abriga o maior rebanho do Brasil. A tuberculose causada pelo Mycobacterium bovis é uma zoonose que leva a perdas severas na criação de búfalos. Apesar de já ter sido descrita no país, dados sobre a ocorrência e distribuição da tuberculose em búfalos no Brasil são escassos. O presente estudo investigou a frequência de tuberculose em búfalos na região do Baixo Araguari, Amapá. Trinta rebanhos, selecionados ao acaso dentre os 41 que criam búfalos na região, foram amostrados. Destes rebanhos, 212 animais selecionados ao acaso foram submetidos à tuberculinização cervical comparativa. A frequência de rebanhos infectados na região do Baixo Araguari foi de 50,0% (CI 95%: 31,3% to 68,7%) e a frequência de animais infectados foi estimada em 14,8% (95% CI: 7,8% to 21,9%). Nossos resultados mostram que a tuberculose está amplamente distribuída em búfalos da região do Baixo Araguari, Amapá e que medidas de controle da doença devem ser implementadas na região.(AU)

Tuberculosis in water buffalo (Bubalus bubalis) in the Baixo Araguari Region, Amapá, Brazil / Tuberculose em búfalos (Bubalus bubalis) na região do Baixo Araguari, Amapá, Brazil

Water buffalo are of great economic importance in Brazilian Amazonia, which has the largest herd in Brazil. Bovine tuberculosis caused by Mycobacterium bovis is a zoonotic disease that results in severe losses to water buffalo production. Although the disease has already been described in the country, data on the occurrence and distribution of bovine tuberculosis in water buffalo in Brazil is very scarce. The aim of this study was to determine the frequency of bovine tuberculosis in water buffalo in the Baixo Araguari River region of Amapá, Brazil. Thirty herds, randomly selected from the 41 herds of water buffalo in the region, were sampled. From those herds, 212 randomly selected water buffalo were subjected to the comparative tuberculin skin test. The proportion of Baixo Araguari River region herds that were positive for bovine tuberculosis was 50.0% (95% CI 31.3% to 68.7%) and the proportion of animals that were positive was estimated to be 14.8% (95% CI 7.8% to 21.9%). Our results show that bovine tuberculosis is spread widely among water buffalo in the Baixo Araguari River region, which suggests that measures to control the disease should be undertaken in the region.

A criação de búfalos é de grande importância econômica na Região Amazônica, que abriga o maior rebanho do Brasil. A tuberculose causada pelo Mycobacterium bovis é uma zoonose que leva a perdas severas na criação de búfalos. Apesar de já ter sido descrita no país, dados sobre a ocorrência e distribuição da tuberculose em búfalos no Brasil são escassos. O presente estudo investigou a frequência de tuberculose em búfalos na região do Baixo Araguari, Amapá. Trinta rebanhos, selecionados ao acaso dentre os 41 que criam búfalos na região, foram amostrados. Destes rebanhos, 212 animais selecionados ao acaso foram submetidos à tuberculinização cervical comparativa. A frequência de rebanhos infectados na região do Baixo Araguari foi de 50,0% (CI 95%: 31,3% to 68,7%) e a frequência de animais infectados foi estimada em 14,8% (95% CI: 7,8% to 21,9%). Nossos resultados mostram que a tuberculose está amplamente distribuída em búfalos da região do Baixo Araguari, Amapá e que medidas de controle da doença devem ser implementadas na região.

Draft Genome Sequence of Mycobacterium bovis Strain AN5, Used for Production of Purified Protein Derivative.

Mycobacterium bovis strain AN5 has been used to produce purified protein derivative (PPD) for the intradermal test for bovine tuberculosis since it was introduced in 1948. This work reports the draft genome sequence of M. bovis AN5, which is used for the production of bovine PPD in Brazil, as well as comparisons to other strains of M. bovis and Mycobacterium tuberculosis.

Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil.

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.

Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on Löwenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials.

Planejamento e execução de revisões sistemáticas da literatura / Planning and execution of systematic literature reviews

Tendo em vista que as revisões sistemáticasda literatura têm sido a principal fontede informação para adoção da prática baseada emevidências, e que são escassas as publicações nacionaisque orientem o processo de sua elaboração, oartigo apresenta as etapas de planejamento dessetipo de revisão.

Considering that systematic literature reviews have been the main source of information for the adoption of evidence-based practice and that there are few national publications to guide the process of preparing systematic literature reviews, this article presents the steps for planning and executing this process.

Parameter estimation and use of gamma interferon assay for the diagnosis of bovine tuberculosis in Brazil / Estimação dos parâmetros e uso do teste do interferon gama para o diagnóstico da tuberculose bovina no Brasil

This study aimed to evaluate the interference of tuberculin test on the gamma-interferon (INFg) assay, to estimate the sensitivity and specificity of the INFg assay in Brazilian conditions, and to simulate multiple testing using the comparative tuberculin test and the INFg assay. Three hundred-fifty cattle from two TB-free and two TB-infected herds were submitted to the comparative tuberculin test and the INFg assay. The comparative tuberculin test was performed using avian and bovine PPD. The INFg assay was performed by the BovigamTM kit (CSL Veterinary, Australia), according to the manufacturer's specifications. Sensitivity and specificity of the INFg assay were assessed by a Bayesian latent class model. These diagnostic parameters were also estimate for multiple testing. The results of INFg assay on D0 and D3 after the comparative tuberculin test were compared by the McNemar's test and kappa statistics. Results of mean optical density from INFg assay on both days were similar. Sensitivity and specificity of the INFg assay showed results varying (95% confidence intervals) from 72 to 100% and 74 to 100% respectively. Sensitivity of parallel testing was over 97.5%, while specificity of serial testing was over 99.7%. The INFg assay proved to be a very useful diagnostic method.(AU)

O presente estudo avalia a interferência do teste de tuberculinização no teste do interferon gama (INFg), estima a sensibilidade e a especificidade do INFg em condições brasileiras e simula a utilização dos testes múltiplos usando a tuberculinização comparada e o teste do INFg. Trezentos e cinquenta animais oriundos de dois rebanhos livres e dois rebanhos positivos foram submetidos à tuberculinização comparada e ao teste de INFg. A tuberculinização comparada foi realizada utilizando PPD aviária e bovina. O teste de INFg foi realizado utilizando o kit Bovigam® (CSL Veterinary, Austrália) de acordo com as especificações do fabricante. A sensibilidade e especificidade do teste de INFg foram calculadas pelo Modelo Bayesiano de Classe Latente. Esses parâmetros foram também estimados para os testes múltiplos. Os resultados do teste de INFg no D0 e D3 após o teste de tuberculinização foram comparados pelos testes estatísticos de McNemar e kappa. Os resultados das médias de densidade ótica do teste de INFg em ambos os dias foram similares. A sensibilidade e a especificidade do teste de INFg apresentaram resultados variando (95% intervalo de confiança) de 72 a 100% e 74 a 100%, respectivamente. A sensibilidade do teste em paralelo foi acima de 97,5% enquanto a especificidade do teste em série foi acima de 99,7%. O teste do INFg provou ser um método de diagnóstico muito útil.(AU)

Parameter estimation and use of gamma interferon assay for the diagnosis of bovine tuberculosis in Brazil / Estimação dos parâmetros e uso do teste do interferon gama para o diagnóstico da tuberculose bovina no Brasil

This study aimed to evaluate the interference of tuberculin test on the gamma-interferon (INFg) assay, to estimate the sensitivity and specificity of the INFg assay in Brazilian conditions, and to simulate multiple testing using the comparative tuberculin test and the INFg assay. Three hundred-fifty cattle from two TB-free and two TB-infected herds were submitted to the comparative tuberculin test and the INFg assay. The comparative tuberculin test was performed using avian and bovine PPD. The INFg assay was performed by the BovigamTM kit (CSL Veterinary, Australia), according to the manufacturer's specifications. Sensitivity and specificity of the INFg assay were assessed by a Bayesian latent class model. These diagnostic parameters were also estimate for multiple testing. The results of INFg assay on D0 and D3 after the comparative tuberculin test were compared by the McNemar's test and kappa statistics. Results of mean optical density from INFg assay on both days were similar. Sensitivity and specificity of the INFg assay showed results varying (95% confidence intervals) from 72 to 100% and 74 to 100% respectively. Sensitivity of parallel testing was over 97.5%, while specificity of serial testing was over 99.7%. The INFg assay proved to be a very useful diagnostic method.(AU)

O presente estudo avalia a interferência do teste de tuberculinização no teste do interferon gama (INFg), estima a sensibilidade e a especificidade do INFg em condições brasileiras e simula a utilização dos testes múltiplos usando a tuberculinização comparada e o teste do INFg. Trezentos e cinquenta animais oriundos de dois rebanhos livres e dois rebanhos positivos foram submetidos à tuberculinização comparada e ao teste de INFg. A tuberculinização comparada foi realizada utilizando PPD aviária e bovina. O teste de INFg foi realizado utilizando o kit Bovigam® (CSL Veterinary, Austrália) de acordo com as especificações do fabricante. A sensibilidade e especificidade do teste de INFg foram calculadas pelo Modelo Bayesiano de Classe Latente. Esses parâmetros foram também estimados para os testes múltiplos. Os resultados do teste de INFg no D0 e D3 após o teste de tuberculinização foram comparados pelos testes estatísticos de McNemar e kappa. Os resultados das médias de densidade ótica do teste de INFg em ambos os dias foram similares. A sensibilidade e a especificidade do teste de INFg apresentaram resultados variando (95% intervalo de confiança) de 72 a 100% e 74 a 100%, respectivamente. A sensibilidade do teste em paralelo foi acima de 97,5% enquanto a especificidade do teste em série foi acima de 99,7%. O teste do INFg provou ser um método de diagnóstico muito útil.(AU)