Estimation of diagnostic test characteristics and prevalence of Giardia duodenalis in dairy calves in Belgium using a Bayesian approach.

A Bayesian approach was used to determine both the test properties of three diagnostic test procedures and the prevalence of Giardia duodenalis in dairy calves in Belgium. A cross-sectional survey was conducted in the province of East Flanders, Belgium. Between September 2001 and December 2003, a total of 100 farms were visited and faecal samples were obtained rectally from 499 calves aged from newborn to 70 days. Because there is no gold standard for the diagnosis of a G. duodenalis infection in dairy calves, a subset of 235 samples obtained on the first 50 farms, was examined using three different assays: microscopical examination, an immunofluorescence assay (IFA) and an antigen detecting Elisa (ELISA). Based on the results of these three tests, Bayesian analysis indicated that the prevalence of G. duodenalis in dairy calves was 0.19 (95% Confidence Interval: 0.11-0.28) and that ELISA (Sensitivity (Se) 0.89 and Specificity (Sp): 0.90) and IFA (Se: 0.77 and Sp: 0.95) were both sensitive and specific diagnostic techniques, whereas microscopical examination was less sensitive (Se: 0.56 and Sp: 0.87). The proportion of positive farms was estimated as 0.42 (0.24-0.62). The prevalence and the cyst excretion in calves from different age categories were based on data obtained by IFA on all 499 samples. The prevalence was highest among four to five week old calves and remained high among older calves up to 10 weeks, but was lower among calves before the age of two weeks. The number of excreted cysts was estimated by IFA and ranged from 100 to 1,040,000 cysts per gram faeces, with a mean of 3516 cysts per gram faeces. The intensity of excretion peaked among four-week-old calves and remained high among calves up to the age of eight weeks. This is the first known study to use Bayesian analysis to estimate the prevalence of G. duodenalis in the faeces of dairy calves and to estimate test characteristics of diagnostic assays used for the detection of G. duodenalis.