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Research Question
What is the diagnostic performance of current tuberculosis tests for distinguishing Mycobacterium bovis from Mycobacterium tuberculosis in humans and animals?
AI Novelty Assessment
Moderate Novelty
This question builds on existing work but introduces a fresh angle or combination of ideas.
Detailed Analysis
The literature clearly covers diagnostic tools for bovine TB in cattle, wildlife, and broader human zoonotic TB diagnosis challenges. However, most studies address either animal-side test performance or human diagnostic limitations separately, rather than a unified evaluation of how current tests distinguish M. bovis from M. tuberculosis across both humans and animals. A cross-host comparative diagnostic-performance study with head-to-head test accuracy metrics and species-specific differentiation would still fill a meaningful gap, so the question is moderately novel rather than fully established.
Related Academic Papers
11 papers found relevant to this research question. Each paper is scored by how closely it relates to the question.
W. Waters, H. Vordermeier, S. Rhodes, Bhagwati Khatri, M. Palmer, M. F. Maggioli, T. Thacker, Jeffrey T. Nelson, B. Thomsen, S. Robbe-Austerman, Doris M Bravo Garcia, M. Schoenbaum, M. Camacho, Jean S. Ray, J. Esfandiari, P. Lambotte, R. Greenwald, A. Grandison, Alina Sikar-Gang, K. Lyashchenko (2017)
Abstract
BackgroundBovine tuberculosis (TB) control programs generally rely on the tuberculin skin test (TST) for ante-mortem detection of Mycobacterium bovis-infected cattle.ResultsPresent findings demonstrate that a rapid antibody test based on Dual-Path Platform (DPP®) technology, when applied 1-3 weeks after TST, detected 9 of 11 and 34 of 52 TST non-reactive yet M. bovis-infected cattle from the US and GB, respectively. The specificity of the assay ranged from 98.9% (n = 92, US) to 96.0% (n = 50, GB) with samples from TB-free herds. Multi-antigen print immunoassay (MAPIA) revealed the presence of antibodies to multiple antigens of M. bovis in sera from TST non-reactors diagnosed with TB.ConclusionsThus, use of serologic assays in series with TST can identify a significant number of TST non-reactive tuberculous cattle for more efficient removal from TB-affected herds.
Why this paper is relevant
Directly evaluates a serologic assay to identify cattle with Mycobacterium bovis infection and discusses combining serology with skin testing to improve detection.
S. Parsons, K. McGill, M. Doyle, W. Goosen, P. V. van Helden, E. Gormley (2016)
Abstract
The most widely used ante-mortem diagnostic tests for tuberculosis in cattle are the tuberculin skin test and the interferon-gamma (IFN-γ) release assay, both of which measure cell-mediated immune responses to Mycobacterium bovis infection. However, limitations in the performance of these tests results in a failure to identify all infected animals. In attempting to increase the range of diagnostic tests for tuberculosis, measurement of the cytokine IP-10 in antigen-stimulated blood has previously been shown to improve the detection of M. tuberculosis and M. bovis infection, in humans and African buffaloes (Syncerus caffer), respectively. In the present study, 60 cattle were identified by the single intradermal comparative tuberculin test as tuberculosis reactors (n = 24) or non-reactors (n = 36) and the release of IFN-γ and IP-10 in antigen-stimulated whole blood from these animals was measured using bovine specific ELISAs. There was a strong correlation between IP-10 and IFN-γ production in these samples. Moreover, measurement of the differential release of IP-10 in response to stimulation with M. bovis purified protein derivative (PPD) and M. avium PPD distinguished between reactor and non-reactor cattle with a sensitivity of 100% (95% CI, 86%–100%) and a specificity of 97% (95% CI, 85%–100%). These results suggest that IP-10 might prove valuable as a diagnostic biomarker of M. bovis infection in cattle.
Why this paper is relevant
Assesses antigen-specific IP-10 as a biomarker in M. bovis-infected cattle; highly relevant to test performance in animals.
S. Luciano, A. Roess (2020)
Abstract
Zoonotic tuberculosis (zTB) accounts for 1.4% of the global tuberculosis burden, with the largest disease burden in low‐ and middle‐income countries (LMICs). These populations have increased exposure to zTB due to livestock rearing practices and raw dairy consumption. This qualitative systematic literature review evaluates the quality of the literature that examines the association between human zTB in LMICs and frequent exposure to livestock and livestock products and summarizes current gaps in laboratory detection methods.
Why this paper is relevant
Systematic review focused on laboratory diagnosis challenges for human zoonotic tuberculosis, directly relevant to distinguishing M. bovis from M. tuberculosis in humans.
Katrin Smith, Netanya Bernitz, D. Cooper, T. J. Kerr, Candice R de Waal, Charlene Clarke, Samantha Goldswain, W. McCALL, Alicia J. McCall, D. Cooke, Emma Rambert, L. Kleynhans, R. Warren, P. V. van Helden, S. Parsons, W. Goosen, Michele A. Miller (2021)
Abstract
Effective screening methods are critical for preventing the spread of bovine tuberculosis (bTB) among livestock and wildlife species. The tuberculin skin test (TST) remains the primary test for bTB globally, although performance is suboptimal. African buffaloes (Syncerus caffer) are a maintenance host of Mycobacterium bovis in South Africa, tested using the single intradermal tuberculin test (SITT) or comparative test (SICTT). The interpretation of these tests has been based on cattle thresholds due to the lack of species-specific cut-off values for African buffaloes. Therefore, the aims of this study were to calculate buffalo-specific thresholds for different TST criteria (SITT, SICTT, and SICTT72h that calculates the differential change at 72 h only) and compare performance using these cut-off values. The results confirm that 3 mm best discriminates M. bovis-infected from unexposed control buffaloes with sensitivities of 69 % (95 % CI 60-78; SITT and SICTT) and 76 % (95 % CI 65-83; SICTT72h), and specificities of 86 % (95 % CI 80-90; SITT), 96 % (95 % CI 92-98; SICTT72h) and 97 % (95 % CI 93-99; SICTT), respectively. A comparison between TST criteria using buffalo-specific thresholds demonstrates that the comparative TST performs better than the SITT, although sensitivity remains suboptimal. Therefore, further research and the addition of ancillary tests, such as cytokine release assays, are necessary to improve M. bovis detection in African buffaloes.
Why this paper is relevant
Optimisation of tuberculin skin testing in African buffaloes; relevant to test performance in wildlife reservoirs.
Katrin Smith, L. Kleynhans, R. Warren, W. Goosen, Michele A. Miller (2021)
Abstract
Mycobacterium bovis has the largest host range of the Mycobacterium tuberculosis complex and infects domestic animal species, wildlife, and humans. The presence of global wildlife maintenance hosts complicates bovine tuberculosis (bTB) control efforts and further threatens livestock and wildlife-related industries. Thus, it is imperative that early and accurate detection of M. bovis in all affected animal species is achieved. Further, an improved understanding of the complex species-specific host immune responses to M. bovis could enable the development of diagnostic tests that not only identify infected animals but distinguish between infection and active disease. The primary bTB screening standard worldwide remains the tuberculin skin test (TST) that presents several test performance and logistical limitations. Hence additional tests are used, most commonly an interferon-gamma (IFN-γ) release assay (IGRA) that, similar to the TST, measures a cell-mediated immune (CMI) response to M. bovis. There are various cytokines and chemokines, in addition to IFN-γ, involved in the CMI component of host adaptive immunity. Due to the dominance of CMI-based responses to mycobacterial infection, cytokine and chemokine biomarkers have become a focus for diagnostic tests in livestock and wildlife. Therefore, this review describes the current understanding of host immune responses to M. bovis as it pertains to the development of diagnostic tools using CMI-based biomarkers in both gene expression and protein release assays, and their limitations. Although the study of CMI biomarkers has advanced fundamental understanding of the complex host-M. bovis interplay and bTB progression, resulting in development of several promising diagnostic assays, most of this research remains limited to cattle. Considering differences in host susceptibility, transmission and immune responses, and the wide variety of M. bovis-affected animal species, knowledge gaps continue to pose some of the biggest challenges to the improvement of M. bovis and bTB diagnosis.
Why this paper is relevant
Reviews cell-mediated immunological biomarkers for M. bovis in livestock and wildlife; relevant to diagnostic discrimination across hosts.
Archana A. Sridhara, Ashley Johnathan-Lee, Rubyat Elahi, P. Lambotte, J. Esfandiari, M. Boschiroli, T. J. Kerr, Michele A. Miller, Thomas M. Holder, G. Jones, H. Vordermeier, Breanne N. Marpe, T. Thacker, M. Palmer, W. Waters, K. Lyashchenko (2022)
Abstract
Recent studies have suggested the potential of innovative serologic tests for accurate and rapid detection of bovine tuberculosis (bTB). Dual Path Platform (DPP) technology has been used to develop rapid animal-side antibody tests for Mycobacterium bovis infection in a range of livestock and wildlife host species. The present study evaluated diagnostic performance of DPP BovidTB IgM/IgG assay designed for differential detection of bovine IgM and IgG antibodies against two chimeric antigens, DID38 and TBf2, respectively, using 662 well-characterized serum samples from M. bovis-infected and bTB-free cattle collected in the United States, Great Britain, France, and South Africa. Test sensitivity and specificity ranged from 71% to 100% and from 95% to 100%, respectively, depending on the country, with overall accuracy of 83%. No significant risk of cross-reactivity with serum samples from cattle infected with most relevant species of mycobacteria other than M. bovis was found. The DPP BovidTB IgM/IgG assay may be suitable for use in multi-test algorithms to improve current strategies for bTB surveillance.
Why this paper is relevant
Evaluates IgM and IgG responses to chimeric antigens in bovine TB; relevant to alternative serodiagnostics.
T. Xin, Xintao Gao, Hongjun Yang, Pingjun Li, Qianqian Liang, S. Hou, X. Sui, Xiaoyu Guo, W. Yuan, Hongfei Zhu, Jiabo Ding, H. Jia (2018)
Abstract
Bovine tuberculosis (bTB) is primarily caused by infection with Mycobacterium bovis, which belongs to the Mycobacterium tuberculosis complex. The airborne route is considered the most common for transmission of M. bovis, and more than 15% of cattle with bTB shed the Mycobacterium, which can be detect by nested PCR to amplify mycobacterial mpb70 from a nasal swab from a cow. To screen for cytokines fostering early and accurate detection of bTB, peripheral blood mononuclear cells were isolated from naturally M. bovis-infected, experimentally M. bovis 68002-infected, and uninfected cattle, then these cells were stimulated by PPD-B, CFP-10-ESAT-6 (CE), or phosphate-buffered saline (PBS) for 6 h. The levels of interferon gamma (IFN-γ), IFN-γ-induced protein 10 (IP-10), IL-6, IL-12, IL-17A, and tumor necrosis factor alpha mRNA were measured using real-time PCR. To explore the cytokines associated with different periods of M. bovis infection, cattle were divided into three groups: PCR-positive, PCR-negative, and uninfected using the tuberculin skin test, CFP-10/ESAT-6/TB10.4 protein cocktail-based skin test, IFN-γ release assay (IGRA), CFP-10/ESAT-6 (CE)-based IGRA, and nested PCR. The expression of IP-10, IL-17A, and IFN-γ proteins induced by PPD-B, CE, or PBS was detected by ELISA. The results showed that levels of PPD-B-stimulated IL-17A and IP-10 (mRNA and protein), and CE-induced IP-10 (mRNA and protein) were significantly higher in cattle naturally or experimentally infected with M. bovis than in those that were uninfected. The levels of PPD-B- or CE-induced IL-17A and IP-10 (protein) could be used to differentiate M. bovis-infected calves from uninfected ones for 6 to 30 weeks post-infection, whereas PPD-B- and CE-induced IP-10 and IL-17A mRNA expression could be used to differentiate M. bovis-infected calves from uninfected ones between 6 and 58 weeks post-infection. However, CE-induced IL-17A (protein) was not a reliable indicator of M. bovis infection in cattle that were confirmed positive for infection by nested PCR. Furthermore, the levels of PPD-B- or CE-induced IP-10 and IL-17A protein were lower than IFN-γ in M. bovis-infected cattle. Therefore, IL-17A and IP-10 protein are not suitable biomarkers for bTB. Antigen-induced IP-10 mRNA should be analyzed further for their potential to be used in the diagnosis of bTB.
Why this paper is relevant
Discusses limitations of IL-17A and IP-10 biomarkers and their inability to fully solve diagnostic differentiation in cattle.
Eduard Otto Roos, F. Olea-Popelka, P. Buss, Guy Hausler, R. Warren, P. V. van Helden, S. Parsons, L. de Klerk-Lorist, Michele A. Miller (2018)
Abstract
BackgroundBovine tuberculosis (bTB) caused by Mycobacterium bovis has previously been diagnosed in warthogs and infection can be highly prevalent (> 30%) in endemic areas. Thus, warthogs could potentially be an important species to consider as sentinels for disease surveillance. However, disease surveillance is dependent on availability of accurate diagnostic assays and only a few diagnostic tests have been investigated for warthogs. Furthermore, the tests that have been used in this species require laboratory equipment and trained personnel to obtain results. Therefore, this study investigated the use of the intradermal tuberculin test (ITT) to screen warthogs for bTB, which can be done with minimal equipment and under field conditions by most veterinarians and other qualified professionals. Changes in skin fold thickness measurements at the bovine purified protein derivative (PPD) administration site, between 0 and 72 h, were compared with differential changes between the bovine and avian PPD sites, for 34 warthogs, to evaluate the performance when different interpretation criteria for the ITT was used.ResultsUsing an increase of 1.8 mm or more at the bovine PPD site as a cut-off for positive responders, 69% of 16 M. bovis culture-positive warthogs had a positive test result, with 100% of the 18 culture-negative warthogs considered as test negative. When a differential of 1.2 mm or more in skin fold thickness at the bovine PPD compared to the avian PPD site was used as a cut-off for the comparative ITT, 81% of culture-positive warthogs were considered as test positive, with 100% of culture-negative warthogs considered as test negative.ConclusionThe findings in this study suggest that the ITT is a promising tool to use when screening warthogs for M. bovis infection.
Why this paper is relevant
Measures antigen-specific responses using intradermal tuberculin testing in warthogs; relevant for non-bovid animal diagnostics.
Netanya Bernitz, T. J. Kerr, W. Goosen, J. Chileshe, Roxanne L Higgitt, Eduard Otto Roos, Christina Meiring, Rachiel Gumbo, Candice R de Waal, Charlene Clarke, Katrin Smith, Samantha Goldswain, Taschnica T. Sylvester, L. Kleynhans, A. Dippenaar, P. Buss, D. Cooper, K. Lyashchenko, R. Warren, P. V. van Helden, S. Parsons, Michele A. Miller (2021)
Abstract
Wildlife tuberculosis is a major economic and conservation concern globally. Bovine tuberculosis (bTB), caused by Mycobacterium bovis (M. bovis), is the most common form of wildlife tuberculosis. In South Africa, to date, M. bovis infection has been detected in 24 mammalian wildlife species. The identification of M. bovis infection in wildlife species is essential to limit the spread and to control the disease in these populations, sympatric wildlife species and neighboring livestock. The detection of M. bovis-infected individuals is challenging as only severely diseased animals show clinical disease manifestations and diagnostic tools to identify infection are limited. The emergence of novel reagents and technologies to identify M. bovis infection in wildlife species are instrumental in improving the diagnosis and control of bTB. This review provides an update on the diagnostic tools to detect M. bovis infection in South African wildlife but may be a useful guide for other wildlife species.
Why this paper is relevant
Systematic review of diagnostic tests for M. bovis in wildlife; useful for understanding animal-side diagnostic accuracy and limitations.
Hawult Taye, Kassahun Alemu, A. Mihret, J. Wood, Z. Shkedy, S. Berg, A. Aseffa (2021)
Abstract
Tuberculosis (TB) is a chronic communicable bacterial disease caused by Mycobacterium tuberculosis complex (MTBC) species. M. tuberculosis is the main causative agent of human TB, and cattle are the primary host of Mycobacterium bovis; due to close interaction between cattle and humans, M. bovis poses a zoonotic risk. This review summarizes and estimates the prevalence of M. bovis infection among human cases. Studies reporting TB prevalence data that were published in English during 10 years from 20 April 2009 to 17 April 2019 were identified through search of PubMed and other sources. Quality of studies and risk of bias were assessed using standard tools for prevalence study reports. Characteristics of included studies and their main findings were summarized in tables and discussed with narrative syntheses. Meta‐analysis was performed on 19 included studies, with a total of 7,185 MTBC isolates identified; 702 (9.7%) of them were characterized as of subspecies M. bovis, but there was a large prevalence difference between the studies, ranging from 0.4% to 76.7%. The genotyping‐based studies reported significantly lower prevalence of zoonotic TB than did the studies based on older techniques. The overall pooled prevalence of M. bovis aggregated from all included studies was 12.1% of the total MTBC isolates, while the corresponding pooled figure from the 14 genotyping‐based studies was only 1.4%. Generally, human M. bovis cases reported from different countries of the world suggest that the impact of zoonotic TB is still important in all regions. However, it was difficult to understand the true picture of the disease prevalence because of methodological differences. Future investigations on zoonotic TB should carefully consider these differences when evaluating prevalence results.
Why this paper is relevant
Meta-analysis on prevalence of M. bovis among human TB cases; relevant background for why discrimination matters, though not a diagnostic accuracy study.
Jobin Thomas, A. Balseiro, C. Gortázar, M. Risalde (2021)
Abstract
Animal tuberculosis (TB) is a multi-host disease caused by members of the Mycobacterium tuberculosis complex (MTC). Due to its impact on economy, sanitary standards of milk and meat industry, public health and conservation, TB control is an actively ongoing research subject. Several wildlife species are involved in the maintenance and transmission of TB, so that new approaches to wildlife TB diagnosis have gained relevance in recent years. Diagnosis is a paramount step for screening, epidemiological investigation, as well as for ensuring the success of control strategies such as vaccination trials. This is the first review that systematically addresses data available for the diagnosis of TB in wildlife following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The article also gives an overview of the factors related to host, environment, sampling, and diagnostic techniques which can affect test performance. After three screenings, 124 articles were considered for systematic review. Literature indicates that post-mortem examination and culture are useful methods for disease surveillance, but immunological diagnostic tests based on cellular and humoral immune response detection are gaining importance in wildlife TB diagnosis. Among them, serological tests are especially useful in wildlife because they are relatively inexpensive and easy to perform, facilitate large-scale surveillance and can be used both ante- and post-mortem. Currently available studies assessed test performance mostly in cervids, European badgers, wild suids and wild bovids. Research to improve diagnostic tests for wildlife TB diagnosis is still needed in order to reach accurate, rapid and cost-effective diagnostic techniques adequate to a broad range of target species and consistent over space and time to allow proper disease monitoring.
Why this paper is relevant
Systematic review of TB diagnosis in wildlife, providing comparative test context for non-human hosts.
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