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Research
An experts’ opinion-based comparison and benefit cost analysis of post-mortem versus tuberculin skin test surveillance systems, Mpumalanga, South Africa
Folorunso Fasina
Food and Agriculture Organization of the United Nations
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3088-8752
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Tuberculosis (TB) is a global health concern caused mostly by Mycobacterium bovis (M. bovis) and Mycobacterium tuberculosis (M. tuberculosis) in animals and humans respectively. As part of TB control strategies, most governments instituted test and slaughter policies for bovine TB (bTB) eradication with varied level of success.
Methods
Using the SurvCost® (http://www.cdc.gov/idsr/survcost.htm), we evaluated the postmortem surveillance (PMS) system as an alternative to the tuberculin skin test (TST). Experts’opinions survey was used to collect information on the perceived level of acceptability of PMS and TST, successes and challenges of both surveillance systems, economic and budget data. Benefit cost analysis of both systems were evaluated and the comparative economic benefit of PMS over TST was determined.
Results
TST implementation was challenging due to poor logistics, procurement challenge, poor feedback, inconsistency in testing and poor return rate for retesting. Experts agreed that PMS was cheaper but almost impracticable due to late detection and probable poor compliance rate but farmers were more open to PMS than TST. Personnel cost remains the largest part of the surveillance cost (47.8% of total costs). TST and PMS systems can be up to 4.40 and 5.96 times more beneficial that not tackling bTB respectively and PMS is 1.35 more cost beneficial that TST.
Conclusion
While TST is empirical, compliance by farmers was poor due to the associated inconveniences. In the alternative, PMS was convenient for farmers but experts believed that adherence will be poor unless increased manpower is available. We advocated for a blended approach between the two systems. Improved field surveillance and detailed economic data should benefit future economic assessment.
Trial registration
Not applicable.
Keywords
bovine tuberculosis, benefit cost analysis, Mpumalanga, surveillance, zoonosis
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Research
An experts’ opinion-based comparison and benefit cost analysis of post-mortem versus tuberculin skin test surveillance systems, Mpumalanga, South Africa
Folorunso Fasina
Food and Agriculture Organization of the United Nations
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3088-8752
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Tuberculosis (TB) is a global health concern caused mostly by Mycobacterium bovis (M. bovis) and Mycobacterium tuberculosis (M. tuberculosis) in animals and humans respectively. As part of TB control strategies, most governments instituted test and slaughter policies for bovine TB (bTB) eradication with varied level of success.
Methods
Using the SurvCost® (http://www.cdc.gov/idsr/survcost.htm), we evaluated the postmortem surveillance (PMS) system as an alternative to the tuberculin skin test (TST). Experts’opinions survey was used to collect information on the perceived level of acceptability of PMS and TST, successes and challenges of both surveillance systems, economic and budget data. Benefit cost analysis of both systems were evaluated and the comparative economic benefit of PMS over TST was determined.
Results
TST implementation was challenging due to poor logistics, procurement challenge, poor feedback, inconsistency in testing and poor return rate for retesting. Experts agreed that PMS was cheaper but almost impracticable due to late detection and probable poor compliance rate but farmers were more open to PMS than TST. Personnel cost remains the largest part of the surveillance cost (47.8% of total costs). TST and PMS systems can be up to 4.40 and 5.96 times more beneficial that not tackling bTB respectively and PMS is 1.35 more cost beneficial that TST.
Conclusion
While TST is empirical, compliance by farmers was poor due to the associated inconveniences. In the alternative, PMS was convenient for farmers but experts believed that adherence will be poor unless increased manpower is available. We advocated for a blended approach between the two systems. Improved field surveillance and detailed economic data should benefit future economic assessment.
Trial registration
Not applicable.
Figure 1
Figure 2
Figure 3