One of the most commonly observational study design employed in veterinary is the cross-sectional study with binary outcomes. To measure an association with exposure, the use of prevalence ratios (PR) or odds ratios (OR) are possible. In human epidemiology, much has been discussed about the use of the OR exclusively for case-control studies and some authors reported that there is no good justification for fitting logistic regression when the prevalence of the disease is high, in which OR overestimate the PR. Nonetheless, interpretation of OR is difficult since confusing between risk and odds can lead to incorrect quantitative interpretation of data such as “the risk is X times greater”, commonly reported in studies that use OR. The aims of this study were (1) to review articles with cross-sectional designs to assess the statistical method used and the appropriateness of the interpretation of the estimated measure of association and (2) to illustrate the use of alternative statistical methods that estimate PR directly. An overview of statistical methods and its interpretation using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was conducted and included a diverse set of peer-reviewed journals among the veterinary science field using PubMed as the search. From each article the statistical method used and the appropriateness of the interpretation of the estimated measure of association were registered. Additionally, four alternative models for logistic regression that estimate directly PR were tested using our own dataset from a cross-sectional study on bovine viral diarrhea virus. The initial search strategy found 62 articles, in which six articles were excluded and therefore 56 studies were used for the overall analysis. The review showed that independent of the level of prevalence reported, 96% of articles employed logistic regression, thus estimating the OR. Results of the multivariate models indicated that logistic regression was the method that most overestimated the PR. The findings of this study indicate that although there are methods that directly estimate PR, many studies in veterinary science do not use these methods and misinterpret the OR estimated by the logistic regression.
Bovine viral diarrhea virus (BVDV) causes one of the most economically important diseases in cattle, and the virus is found worldwide. A better understanding of the disease associated factors is a crucial step towards the definition of strategies for control and eradication. In this study we trained a random forest (RF) prediction model and performed variable importance analysis to identify factors associated with BVDV occurrence. In addition, we assessed the influence of features selection on RF performance and evaluated its predictive power relative to other popular classifiers and to logistic regression. We found that RF classification model resulted in an average error rate of 32.03% for the negative class (negative for BVDV) and 36.78% for the positive class (positive for BVDV).The RF model presented area under the ROC curve equal to 0.702. Variable importance analysis revealed that important predictors of BVDV occurrence were: a) who inseminates the animals, b) number of neighboring farms that have cattle and c) rectal palpation performed routinely. Our results suggest that the use of machine learning algorithms, especially RF, is a promising methodology for the analysis of cross-sectional studies, presenting a satisfactory predictive power and the ability to identify predictors that represent potential risk factors for BVDV investigation. We examined classical predictors and found some new and hard to control practices that may lead to the spread of this disease within and among farms, mainly regarding poor or neglected reproduction management, which should be considered for disease control and eradication.
12 November 2015 in PLOS Neglected Tropical Diseases
Leptospirosis is an epidemic-prone neglected disease that affects humans and animals, mostly in vulnerable populations. The One Health approach is a recommended strategy to identify drivers of the disease and plan for its prevention and control. In that context, the aim of this study was to analyze the distribution of human cases of leptospirosis in the State of Rio Grande do Sul, Brazil, and to explore possible drivers. Additionally, it sought to provide further evidence to support interventions and to identify hypotheses for new research at the human-animal-ecosystem interface. The risk for human infection was described in relation to environmental, socioeconomic, and livestock variables. This ecological study used aggregated data by municipality (all 496). Data were extracted from secondary, publicly available sources. Thematic maps were constructed and univariate analysis performed for all variables. Negative binomial regression was used for multivariable statistical analysis of leptospirosis cases. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: Parana/Paraiba ecoregion (RR: 2.25; CI95%: 2.03–2.49); Neossolo Litolítico soil (RR: 1.93; CI95%: 1.26–2.96); and, to a lesser extent, the production of tobacco (RR: 1.10; CI95%: 1.09–1.11) and rice (RR: 1.003; CI95%: 1.002–1.04). Urban cases were concentrated in the capital and rural cases in a specific ecoregion. The major drivers identified in this study were related to environmental and production processes that are permanent features of the state. This study contributes to the basic knowledge on leptospirosis distribution and drivers in the state and encourages a comprehensive approach to address the disease in the animal-human-ecosystem interface. Leptospirosis is a bacterial disease affecting humans and several animal species, which serve as reservoirs for infection. Contamination happens through exposure to urine of infected animals in water and soil. A better understanding of the factors that affect the transmission of the disease, incorporating the relationship between humans, animals, and ecosystems within the One Health approach, would allow for tailored prevention and control measures at the local level. The aims of this study were to analyze the distribution of leptospirosis human cases and the possible factors that influence the transmission of the disease in the state of Rio Grande do Sul, as well as provide evidence to support the development of interventions and guide new studies in the region. Leptospirosis cases and possible environmental, socioeconomic, and livestock factors were analyzed. The study used data by municipality (all 496) obtained via an open access database. Georeferenced maps were constructed and statistical analysis performed for 26 variables. A multivariable regression analysis was carried out. An annual average of 428 human cases of leptospirosis was reported in the state from 2008 to 2012. The cumulative incidence in rural populations was eight times higher than in urban populations. Variables significantly associated with leptospirosis cases in the final model were: ecoregion, type of soil and to a lesser extent tobacco and rice production. Results showed that leptospirosis cases were concentrated in the state capital and in specific ecoregions. Environmental and agricultural production processes were identified as possible risk factors and these conditions are probably permanent characteristics of the state. This study contributes to the knowledge on leptospirosis distribution and risk factors in the state, and also highlights the importance of a holistic view and intersectoral approach in preventing the disease.
11 February 2021 in Brazilian Journal of Microbiology