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爱尔兰进一步改善牛结核病复发的控制。

Further improvement in the control of bovine tuberculosis recurrence in Ireland.

机构信息

UCD Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Dublin, Ireland.

出版信息

Vet Rec. 2018 Nov 24;183(20):622. doi: 10.1136/vr.104642. Epub 2018 Aug 31.

Abstract

Ongoing objective assessment of national bovine tuberculosis (bTB) policy in Ireland is important to monitor efforts towards improved bTB control. The study objective was to investigate temporal trends in the risk of herd recurrence. The study included all herds derestricted following a bTB episode ending in 1998, 2008 or 2012. The respective 'study periods' were up to the end of 2001 for 1998-derestricted herds, to the end of 2011 for 2008-derestricted herds, and to the end of 2015 for 2012-derestricted herds. A multivariable Cox proportional-hazard model was developed to examine time to next restriction. The results from the model showed a continuing significant decreasing trend in herd recurrence of bTB in Ireland from 1998 until 2015: herds derestricted in 2008 were 0.75 (95 per cent CI 0.68 to 0.82) times as likely to develop a further restriction compared with 1998 herds, and herds derestricted in 2012 were 0.85 (95per cent CI 0.76 to 0.95) times as likely as 2008 herds. However, despite significant improvements, recurrence of bTB remains a concern, with 30.2 per cent (95 per cent CI 28.0 to 32.4 per cent) of herds derestricted in 2012 being re-restricted over the subsequent three years. Further work is needed to address the two key drivers of herd recurrence, namely residual infection and local reinfection.

摘要

持续对爱尔兰国家牛结核病(bTB)政策进行客观评估,对于监测改善 bTB 控制工作的进展非常重要。本研究的目的是调查畜群复发风险的时间趋势。本研究包括所有在 1998 年、2008 年或 2012 年结束的 bTB 事件后解除限制的畜群。相应的“研究期”分别为 1998 年解除限制的畜群截至 2001 年底,2008 年解除限制的畜群截至 2011 年底,2012 年解除限制的畜群截至 2015 年底。采用多变量 Cox 比例风险模型来检查下一次限制的时间。该模型的结果表明,爱尔兰的 bTB 畜群复发率从 1998 年到 2015 年持续呈显著下降趋势:2008 年解除限制的畜群再次受到限制的可能性是 1998 年畜群的 0.75 倍(95%置信区间 0.68 至 0.82),2012 年解除限制的畜群再次受到限制的可能性是 2008 年畜群的 0.85 倍(95%置信区间 0.76 至 0.95)。然而,尽管取得了显著进展,但 bTB 的复发仍然令人担忧,2012 年解除限制的 30.2%(95%置信区间 28.0%至 32.4%)的畜群在随后的三年内再次受到限制。需要进一步努力解决畜群复发的两个关键驱动因素,即残留感染和局部再感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b89d/6288696/41d887e99643/vetrec-2017-104642f01.jpg

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