Rate of transmission: A major determinant of the cost of clinical mastitis
Rate of transmission: A major determinant of the cost of clinical mastitis
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DOI：
10.3168/jds.2012-6470
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发表时间：
2013-10-01
影响因子：
3.5
通讯作者：
Hudson, C. D.
中科院分区：
文献类型：
--
作者：
Down, P. M.;Green, M. J.;Hudson, C. D.
本研究的目的是使用概率敏感性分析，以评估模型的不同组成部分的相对重要性，旨在估计临床乳腺炎（CM）的成本。特别关注的是病原体传播相对于其他因素（如牛奶价格或治疗费用）的重要性。开发了一个随机蒙特卡罗模型，以模拟奶牛水平的CM病例，并计算5个定义的治疗方案的相关成本。5种治疗方案分别为3 d乳房内抗生素治疗、5 d乳房内抗生素治疗、3 d乳房内和全身抗生素治疗、3 d乳房内和全身抗生素治疗加1 d非甾体类药物治疗、5 d乳房内和全身抗生素治疗。在整个模型中使用了均匀分布，以便能够在一系列临床现实场景中调查CM的成本，而无需指定哪种场景更可能或更不可能。纳入了基于文献值的传播参数分布风险，以模拟病原体传播至未感染奶牛（来自CM治疗后仍处于亚临床感染状态的奶牛）的影响。斯皮尔曼等级相关系数用于评估模型输入值与CM估计成本之间的关系。线性回归模型被用来探索特定自变量的变化对CM成本的影响。传播的风险被认为与CM的成本有最强的关联，其次是细菌学治愈率，扑杀成本和产量损失。其他因素，如牛奶价格，劳动力成本和药品成本的影响相对较小。所有5种治疗方案的CM成本相似。从这项研究的结果表明，当寻求最大限度地减少奶牛群中的CM的经济影响时，应高度重视减少从CM奶牛到未感染奶牛的病原体传播。
The aim of this research was to use probabilistic sensitivity analysis to evaluate the relative importance of different components of a model designed to estimate the cost of clinical mastitis (CM). A particular focus was placed on the importance of pathogen transmission relative to other factors, such as milk price or treatment costs. A stochastic Monte Carlo model was developed to simulate a case of CM at the cow level and to calculate the associated costs for 5 defined treatment protocols. The 5 treatment protocols modeled were 3 d of antibiotic intramammary treatment, 5 d of antibiotic intramammary treatment, 3 d of intramammary and systemic antibiotic treatment, 3 d of intramammary and systemic antibiotic treatment plus 1 d of nonsteroidal antiinflammatory drug treatment, and 5 d of intramammary and systemic antibiotic treatment. Uniform distributions were used throughout the model to enable investigation of the cost of CM over a spectrum of clinically realistic scenarios without specifying which scenario was more or less likely. A risk of transmission parameter distribution, based on literature values, was included to model the effect of pathogen transmission to uninfected cows, from cows that remained subclinically infected after treatment for CM. Spearman rank correlation coefficients were used to evaluate the relationships between model input values and the estimated cost of CM. Linear regression models were used to explore the effect that changes to specific independent variables had on the cost of CM. Risk of transmission was found to have the strongest association with the cost of CM, followed by bacteriological cure rate, cost of culling, and yield loss. Other factors such as milk price, cost of labor, and cost of medicines were of minimal influence in comparison. The cost of CM was similar for all 5 treatment protocols. The results from this study suggest that, when seeking to minimize the economic impact of CM in dairy herds, great emphasis should be placed on the reduction of pathogen transmission from cows with CM to uninfected cows.