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dc.contributor.authorPatterson, Stuart J
dc.contributor.authorClarke, Charlene
dc.contributor.authorClutton-Brock, Timothy
dc.contributor.authorMiller, Michele A
dc.contributor.authorParsons, Sven DC
dc.contributor.authorPfeiffer, Dirk U
dc.contributor.authorVergne, Timothée
dc.contributor.authorDrewe, Julian A
dc.date.accessioned2021-12-22T15:08:35Z
dc.date.available2021-12-22T15:08:35Z
dc.date.issued2021-12-04
dc.identifier.issn2076-2615
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/331719
dc.description.abstractDiagnostic tests are used to classify individual animals' infection statuses. However, validating test performance in wild animals without gold standard tests is extremely challenging, and the issue is further complicated in chronic conditions where measured immune parameters vary over time. Here, we demonstrate the value of combining evidence from different diagnostic approaches to aid interpretation in the absence of gold standards, large sample sizes, and controlled environments. Over a two-year period, we sampled 268 free-living meerkats (Suricata suricatta) longitudinally for Mycobacterium suricattae (a causative agent of tuberculosis), using three ante-mortem diagnostic tests based on mycobacterial culture, and antigen-specific humoral and cell-mediated immune responses, interpreting results both independently and in combination. Post-mortem cultures confirmed M. suricattae infection in 22 animals, which had prior ante-mortem information, 59% (13/22) of which were test-positive on a parallel test interpretation (PTI) of the three ante-mortem diagnostic assays (95% confidence interval: 37-79%). A similar ability to detect infection, 65.7% (95% credible interval: 42.7-84.7%), was estimated using a Bayesian approach to examine PTI. Strong evidence was found for a near doubling of the hazard of death (Hazard Ratio 1.75, CI: 1.14-2.67, p = 0.01), associated with a positive PTI result, thus demonstrating that these test results are related to disease outcomes. For individual tests, small sample sizes led to wide confidence intervals, but replication of conclusions, using different methods, increased our confidence in these results. This study demonstrates that combining multiple methodologies to evaluate diagnostic tests in free-ranging wildlife populations can be a useful approach for exploiting such valuable datasets.
dc.languageen
dc.publisherMDPI AG
dc.subjectdiagnostics
dc.subjectinterpretation
dc.subjectwildlife
dc.subjecttuberculosis
dc.subjectmeerkats
dc.titleCombining Analytical Approaches and Multiple Sources of Information to Improve Interpretation of Diagnostic Test Results for Tuberculosis in Wild Meerkats.
dc.typeArticle
dc.date.updated2021-12-22T15:08:35Z
prism.issueIdentifier12
prism.publicationNameAnimals (Basel)
prism.volume11
dc.identifier.doi10.17863/CAM.79169
dcterms.dateAccepted2021-11-29
rioxxterms.versionofrecord10.3390/ani11123453
rioxxterms.versionVoR
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0/
dc.contributor.orcidPatterson, Stuart J [0000-0002-4907-8373]
dc.contributor.orcidClarke, Charlene [0000-0002-9497-2614]
dc.contributor.orcidClutton-Brock, Timothy [0000-0001-8110-8969]
dc.contributor.orcidMiller, Michele A [0000-0002-5883-6076]
dc.contributor.orcidParsons, Sven DC [0000-0002-9033-9686]
dc.contributor.orcidPfeiffer, Dirk U [0000-0001-7000-0530]
dc.contributor.orcidDrewe, Julian A [0000-0003-0709-8066]
dc.identifier.eissn2076-2615
pubs.funder-project-idEuropean Research Council (294494)
cam.issuedOnline2021-12-04


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