Ante mortem diagnosis of paratuberculosis: a review of accuracies of ELISA, interferon-gamma assay and faecal culture techniques.

Department of Large Animal Sciences, Faculty of Life Sciences, University of Copenhagen, Frederiksberg C, Denmark.
Veterinary Microbiology (Impact Factor: 2.73). 07/2008; 129(3-4):217-35. DOI: 10.1016/j.vetmic.2007.12.011
Source: PubMed

ABSTRACT Infections with Mycobacterium avium subsp. paratuberculosis (MAP) can be latent for years without affecting the animal, but the animal may become infectious or clinical at some point. Diagnosis of paratuberculosis can be a challenge primarily in latent stages of the infection, and different diagnosis interpretations are usually required by the variety of decision makers. The objective of this paper was to provide a critical review of reported accuracies of ELISA tests, interferon-gamma assays (IFN-gamma) and faecal culture (FC) techniques used for diagnosis of three defined target conditions: MAP infected, MAP infectious and MAP affected animals. For each animal species, target condition and diagnostic test-type, sensitivities (Se) and specificities (Sp) were summarised based on a systematic, critical review of information in literature databases. The diagnostic test information often varied substantially for tests of the same type and make, particularly ELISA, which was the most frequently reported test-type. Comparison of the various tests accuracies was generally not possible, but stratification of test-evaluations by target condition improved the interpretation of the test accuracies. Infectious and affected animals can often be detected, but Se for infected animals is generally low. A main conclusion of the review was that the quality of design, implementation and reporting of evaluations of tests for paratuberculosis is generally poor. Particularly, there is a need for better correspondence between the study population and target population, i.e. the subjects chosen for test evaluation should reflect the distribution of animals in the population where the test is intended to be used.

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    ABSTRACT: Mathematical models for infectious disease are often used to improve our understanding of infection biology or to evaluate the potential efficacy of intervention programs. Here, we develop a mathematical model that aims to describe infection dynamics of Mycobacterium avium subspecies paratuberculosis (MAP). The model was developed using current knowledge of infection biology and also includes some components of MAP infection dynamics that are currently still hypothetical. The objective was to show methods for parameter estimation of state transition models and to connect simulation models with detailed real life data. Thereby making model predictions and results of simulations more reflective and predictive of real world situations. Longitudinal field data from a large observational study are used to estimate parameter values. It is shown that precise data, including molecular diagnostics on the obtained MAP strains, results in more precise and realistic parameter estimates. It is argued that modeling of infection disease dynamics is of great value to understand the patho-biology, epidemiology and control of infectious diseases. The quality of conclusions drawn from model studies depend on two key issues; first, the quality of biology that has gone in the process of developing the model structure; second the quality of the data that go into the estimation of the parameters and the quality and quantity of the data that go into model validation. The more real world data that are used in the model building process, the more likely that modeling studies will provide novel, innovative and valid results.
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