Roadmap for development of disease control strategies for bTB

What are we trying to achieve and why? What is the problem we are trying to solve?

• Establish how much infection is in a herd, area or territory (country) as this will influence the level of transmission; what are the trends?
• How well are TB control measures and interventions working?
• Active and/or passive surveillance in cattle is required at national level depending on prevalence to support trade and ensure food safety.
• Establishing the prevalence of TB in wildlife via surveillance.
• Establishing the level of M. bovis infection in humans.
• Establishing the level of M. tuberculosis in cattle.
• Development of key performance indicators of testers.

What are the scientific and technological challenges (knowledge gaps needing to be addressed)?

• Performance characteristics of current tests.
• Active and passive cattle surveillance tests and lab confirmation, while specific, have well documented variable (moderate) sensitivity and give a measure of apparent prevalence, which underestimates true prevalence.
• Challenge to maximise yield of test positives within herds using test combinations.
• Wildlife surveillance tests have relatively limited sensitivity.
• Testing can be confounded by factors, such as coinfections, non-communicable disease, nutrition, stress etc.
• Knowing when best to apply the GIFN test.
• Importance of anergic animals.

What approaches could/should be taken to address the research question?

• Regular testing of cattle using diagnostic algorithm i.e., combination of tests based on estimated performance
  characteristics.
• Routine testing of livestock
• Capture and testing of wildlife populations or roadkill surveillance.

What else needs to be done before we can solve this need?

• The development, evaluation, and validation of more rapid, sensitive, and specific diagnostics.
• Understanding and monitoring test performance characteristics (epidemiology) and configuring testing algorithms.

Existing knowledge including successes and failures