Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.

<h4>Background</h4>Diagnosis is key to control and prevention of livestock diseases. In areas of sub-Saharan Africa where private practitioners rarely replace Government veterinary services reduced in effectiveness by structural adjustment programmes, those who remain lack resources for...

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Autores principales:	Mark C Eisler, Joseph W Magona, Crawford W Revie
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/857539fab0ee40939b80ea1cef93ba2b
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spelling	oai:doaj.org-article:857539fab0ee40939b80ea1cef93ba2b2021-11-18T07:12:39ZDiagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.1932-620310.1371/journal.pone.0040687https://doaj.org/article/857539fab0ee40939b80ea1cef93ba2b2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22808233/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Diagnosis is key to control and prevention of livestock diseases. In areas of sub-Saharan Africa where private practitioners rarely replace Government veterinary services reduced in effectiveness by structural adjustment programmes, those who remain lack resources for diagnosis and might benefit from decision support.<h4>Methodology/principal findings</h4>We evaluated whether a low-cost diagnostic decision support tool would lead to changes in clinical diagnostic practice by fifteen veterinary and animal health officers undertaking primary animal healthcare in Uganda. The eight diseases covered by the tool included 98% of all bovine diagnoses made before or after its introduction. It may therefore inform proportional morbidity in the area; breed, age and geographic location effects were consistent with current epidemiological understanding. Trypanosomosis, theileriosis, anaplasmosis, and parasitic gastroenteritis were the most common conditions among 713 bovine clinical cases diagnosed prior to introduction of the tool. Thereafter, in 747 bovine clinical cases estimated proportional morbidity of fasciolosis doubled, while theileriosis and parasitic gastroenteritis were diagnosed less commonly and the average number of clinical signs increased from 3.5 to 4.9 per case, with 28% of cases reporting six or more signs compared to 3% beforehand. Anaemia/pallor, weakness and staring coat contributed most to this increase, approximately doubling in number and were recorded in over half of all cases. Finally, although lack of a gold standard hindered objective assessment of whether the tool improved the reliability of diagnosis, informative concordance and misclassification matrices yielded useful insights into its role in the diagnostic process.<h4>Conclusions/significance</h4>The diagnostic decision support tool covered the majority of diagnoses made before or after its introduction, leading to a significant increase in the number of clinical signs recorded, suggesting this as a key beneficial consequence of its use. It may also inform approximate proportional morbidity and represent a useful epidemiological tool in poorly resourced areas.Mark C EislerJoseph W MagonaCrawford W ReviePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 7, p e40687 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mark C Eisler Joseph W Magona Crawford W Revie Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
description	<h4>Background</h4>Diagnosis is key to control and prevention of livestock diseases. In areas of sub-Saharan Africa where private practitioners rarely replace Government veterinary services reduced in effectiveness by structural adjustment programmes, those who remain lack resources for diagnosis and might benefit from decision support.<h4>Methodology/principal findings</h4>We evaluated whether a low-cost diagnostic decision support tool would lead to changes in clinical diagnostic practice by fifteen veterinary and animal health officers undertaking primary animal healthcare in Uganda. The eight diseases covered by the tool included 98% of all bovine diagnoses made before or after its introduction. It may therefore inform proportional morbidity in the area; breed, age and geographic location effects were consistent with current epidemiological understanding. Trypanosomosis, theileriosis, anaplasmosis, and parasitic gastroenteritis were the most common conditions among 713 bovine clinical cases diagnosed prior to introduction of the tool. Thereafter, in 747 bovine clinical cases estimated proportional morbidity of fasciolosis doubled, while theileriosis and parasitic gastroenteritis were diagnosed less commonly and the average number of clinical signs increased from 3.5 to 4.9 per case, with 28% of cases reporting six or more signs compared to 3% beforehand. Anaemia/pallor, weakness and staring coat contributed most to this increase, approximately doubling in number and were recorded in over half of all cases. Finally, although lack of a gold standard hindered objective assessment of whether the tool improved the reliability of diagnosis, informative concordance and misclassification matrices yielded useful insights into its role in the diagnostic process.<h4>Conclusions/significance</h4>The diagnostic decision support tool covered the majority of diagnoses made before or after its introduction, leading to a significant increase in the number of clinical signs recorded, suggesting this as a key beneficial consequence of its use. It may also inform approximate proportional morbidity and represent a useful epidemiological tool in poorly resourced areas.
format	article
author	Mark C Eisler Joseph W Magona Crawford W Revie
author_facet	Mark C Eisler Joseph W Magona Crawford W Revie
author_sort	Mark C Eisler
title	Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
title_short	Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
title_full	Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
title_fullStr	Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
title_full_unstemmed	Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.
title_sort	diagnosis of cattle diseases endemic to sub-saharan africa: evaluating a low cost decision support tool in use by veterinary personnel.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/857539fab0ee40939b80ea1cef93ba2b
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Diagnosis of cattle diseases endemic to sub-Saharan Africa: evaluating a low cost decision support tool in use by veterinary personnel.

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