Jacobs C, Beninger C, Hazlewood G S, Orsel K, Barkema H W
Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
Prev Vet Med. 2019 Mar 1;164:56-71. doi: 10.1016/j.prevetmed.2019.01.011. Epub 2019 Jan 28.
Digital dermatitis (DD) is an infectious bacterial disease affecting cattle feet. Footbaths are a common herd-level control method for DD; however, variations in product, concentration, and frequency of use complicate comparisons between protocols. The objective of this systematic review was to evaluate all walk-through footbath protocols reported that determined efficacy for prevention and treatment of DD lesions in dairy cattle. An extensive literature search was conducted, including electronic databases and gray literature updated until March 2018. Studies identified included all liquid walk-through footbath protocols that were compared to other footbath protocols or no footbath. Only studies with treatment or prevention of DD lesions as an outcome were included. Literature search and subsequent screening identified 14 publications with 24 treatment comparisons and 24 prevention comparisons. Studies included mostly had low and/or unclear risks of bias. Descriptive analyses were performed according to prevention and treatment outcomes, with case and success definitions summarized as odds ratios (OR). A subsequent network meta-analysis was conducted of 11 studies, comparing 17 protocol comparisons for the prevention outcome and 10 studies comparing 19 protocol comparisons for the treatment outcome, using semi-informative priors in a Bayesian statistical framework. Results of a random effects Bayesian network meta-analysis indicated only 5% copper sulfate used at least 4 times/wk was superior to both no footbath (OR: 5.26; 95% CrI: 1.27-28.8) and a water placebo (OR: 9.47; 95% CrI: 1.03-85.8) in treatment of DD. No other protocol was associated with a reduction in DD, and there were no differences in pair-wise comparisons between any active treatments. Unfortunately, for both outcomes (treatment and prevention), small sample sizes (adjusted for clustering) limited the power to detect substantial differences between protocol effects. Thus, despite widespread use of footbaths, limited strength of evidence for use remains and standardized protocols with large sample sizes are needed to further investigate effectiveness of footbath protocols for control of DD. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
趾间皮炎（DD）是一种影响牛蹄的传染性细菌性疾病。足部药浴是一种常见的针对DD的畜群水平控制方法；然而，产品、浓度和使用频率的差异使得不同方案之间的比较变得复杂。本系统评价的目的是评估所有已报道的通过式足部药浴方案，这些方案确定了对奶牛DD病变的预防和治疗效果。进行了广泛的文献检索，包括电子数据库和截至2018年3月更新的灰色文献。纳入的研究包括所有与其他足部药浴方案或不进行足部药浴进行比较的液体通过式足部药浴方案。仅纳入以治疗或预防DD病变为结果的研究。文献检索及后续筛选确定了14篇出版物，其中有24项治疗比较和24项预防比较。纳入的研究大多存在低和/或不明确的偏倚风险。根据预防和治疗结果进行描述性分析，将病例和成功定义总结为比值比（OR）。随后对11项研究进行了网络荟萃分析，在贝叶斯统计框架下使用半信息先验，比较了17项预防结果的方案比较和10项治疗结果的19项方案比较。随机效应贝叶斯网络荟萃分析结果表明，每周至少使用4次的5%硫酸铜在治疗DD方面优于不进行足部药浴（OR：5.26；95% CrI：1.27 - 28.8）和水安慰剂（OR：9.47；95% CrI：1.03 - 85.8）。没有其他方案与DD的减少相关，并且任何积极治疗之间的两两比较没有差异。不幸的是，对于治疗和预防这两个结果，小样本量（针对聚类进行调整）限制了检测方案效果之间实质性差异的能力。因此，尽管足部药浴被广泛使用，但使用证据的强度仍然有限，需要大样本量的标准化方案来进一步研究足部药浴方案对控制DD的有效性。本研究未获得公共、商业或非营利部门资助机构的任何特定资助。
