Capacity of a Bayesian model to detect infected herds using disease dynamics and risk factor information from surveillance programmes: A simulation study.

Control programmes against non-regulated infectious diseases of farm animals are widely implemented. Different control programmes have different definitions of "freedom from infection" which can lead to difficulties when trading animals between countries. When a disease is still present, in order to identify herds that are safe to trade with, estimating herd-level probabilities of being infected when classified "free from infection" using field data is of major interest. Our objective was to evaluate the capacity of a Bayesian Hidden Markov Model, which computes a herd-level probability of being infected, to detect infected herds compared to using test results only. Herd-level risk factors, infection dynamics and associated test results were simulated in a population of herds, for a wide range of realistic infection contexts and test characteristics. The model was used to predict the infection status of each herd from longitudinal data: a simulated risk factor and a simulated test result. Two different indexes were used to categorize herds from the probability of being infected into a herd predicted status. The model predictive performances were evaluated using the simulated herd status as the gold standard. The model detected more infected herds than a single final test in 85 % of the scenarios which converged. The proportion of infected herds additionally detected by the model, compared to test results alone, varied depending on the context. It was higher in a context of a low herd test sensitivity. On average, around 20 %, for high test sensitivity scenarios, and 40 %, for low test sensitivity scenarios, of infected herds that were undetected by the test were accurately classified as infected by the model. Model convergence did not occur for 39 % of the scenarios, mainly in association with low herd test sensitivity. Detection of additional newly infected herds was always associated with an increased number of false positive herds (except for one scenario). The number of false positive herds was lower for scenarios with low herd test sensitivity and moderate to high incidence and prevalence. These results highlight the benefit of the model, in particular for control programmes with infection present at an endemic level in a population and reliance on test(s) of low sensitivity.