diagnostic accuracy and optimal use of three tests for tuberculosis in live badgers肺结核的诊断准确性和最佳使用三个测试在獾.pdfVIP

Diagnostic Accuracy and Optimal Use of Three Tests for Tuberculosis in Live Badgers 1,2 2 2 2 Julian A. Drewe *, Alexandra J. Tomlinson , Neil J. Walker , Richard J. Delahay 1 Centre for Emerging, Endemic and Exotic Diseases, Royal Veterinary College, London, United Kingdom, 2 Food and Environment Research Agency, Woodchester Park, Gloucestershire, United Kingdom Abstract Background: Accurate diagnosis of tuberculosis (TB) due to infection with Mycobacterium bovis is notoriously difficult in live animals, yet important if we are to understand the epidemiology of TB and devise effective strategies to limit its spread. Currently available tests for diagnosing TB in live Eurasian badgers (Meles meles) remain unvalidated against a reliable gold standard. The aim of the present study was to evaluate the diagnostic accuracy and optimal use of three tests for TB in badgers in the absence of a gold standard. Methodology/Principal Findings: A Bayesian approach was used to evaluate the diagnostic accuracy and optimal use of mycobacterial culture, gamma-interferon assay and a commercially available serological test using multiple samples collected from 305 live wild badgers. Although no single test was judged to be sufficiently sensitive and specific to be used as a sole diagnostic method, selective combined use of the three tests allowed guidelines to be formulated that allow a diagnosis to be made for individual animals with an estimated overall accuracy of 93% (range: 75% to 97%). Employing this approach in the study population of badgers resulted in approximately 13 out of 14 animals having their true infection status correctly classified from samples collected on a single capture. Conclusions/Significance: This met