The emergence and increasing geographic spread of infectious animal diseases, such as the recent incursions of bluetongue virus to Europe and African Swine Fever into Georgia and the Caucasus, serve as a reminder of the threat that infectious animal diseases can pose to security of food supplies as well as to animal welfare and economic growth and human health in certain circumstances. Speed of diagnosis is an important aspect of animal disease control and recent technological developments offer the prospect of more rapid diagnosis and consequent opportunities for reducing the social and economic impact of livestock disease.
The practical impact of rapid/Point of Care (POC) devices depends not only on their technical capabilities but also on the willingness of vets and animal keepers to use them and the circumstances in which they are adopted. Whilst there has been considerable research on attitudes to biosecurity and to infectious diseases in food animals, there appears to have been no research conducted to date on attitudes to diagnostics.
The research reported here examined attitudes of vets and farmers/food chain professionals to rapid/POC devices in the context of both notifiable and endemic disease control in food animals and horses. Particular impetus for the research was provided by the setting up of a Detection and Identification of Infectious Agents Innovation Platform by the UK Technology Strategy Board in October 2008 with the aim of supporting the development and adoption of clinically useful and commercially viable diagnostic tests in areas identified as priority by the UK Department of Health and Department for environment, food and rural affairs (Defra).
Aims and objectives
To gather insights into the deployment of Point of Care (‘pen-side’) veterinary diagnostic technologies, specifically:
- Review existing evidence on these new technologies
- Outline possible impacts on the user community (including unintended consequences)
- Explore users’ attitudes towards and interaction with the diagnostic technologies and identify drivers and barriers to adoption by food chain professionals and practitioners
- Inform and clarify policy implications
Information for this project was collected Sept-Dec 2009 from 41 semi-structured interviews with stakeholders and a one-day workshop with 38 participants (including diagnostic manufacturers) devised in collaboration with the Technology Strategy Board. Additional material was obtained from attending the Veterinary Laboratories Agency International Conference on Animal Diseases on 2nd September 2009. A small number of additional unstructured, scoping interviews were also conducted (n=8).
Questions in the semi-structured interviews focussed around key issues in control of infectious animal diseases, reactions to the potential deployment of pen-side diagnostics, barriers and enablers of uptake of diagnostics and data collection issues.
- Rapid/POC devices were perceived to have some potential advantages. In the context of notifiable diseases these clustered around applications that gave early indication of the presence of a notifiable disease for further confirmation using standard laboratory tests. In the context of endemic diseases, rapidity of diagnosis was generally perceived to be less of a benefit whereas the ability to test ‘on-farm’ was perceived to have some benefits. However, the rapid/POC nature of tests was also entangled with the need for improved diagnostic tests for diseases such as Campylobacter and bovine TB.
- The main barrier to adoption of rapid/POC devices was lack of confidence in the reliability of results from these devices. As the consequences of the decision made with the aid of these devices increases (from changing treatments, to culling individual animals, to declaring a disease outbreak) the need for confidence becomes more acute. Allied with lack of confidence in test results were concerns about loss of control of communication regarding the prevailing disease situation and potential loss of information for disease surveillance and epidemiological study.
- Rapid/POC devices codify the complex knowledge of laboratory testing into an easily understandable format. As a result there may be a temptation to over-rely on these devices, devalue clinical judgements and as a result misdiagnose disease.
- The small group of farmers interviewed for this research indicated their potential interest in using these devices, subject to cost and usability. They further indicated their continuing reliance on veterinary expertise to support any us of these device: to advise on appropriate devices to use, how to use them and in interpreting and acting on the output. The sample of farmers was however small and since these devices are not currently readily available, views and attitudes could change with increasing experience.
- These devices are being introduced at a time when the control of animal disease in the UK is in flux. The increasing stress on governance and the Responsibility and Cost Sharing agenda is likely to result in shifting relationships among government, vets and farmers. Many respondents identified relationships among farmers, vets and government as key to how these devices might be adopted in practice, thus the landscape within which devices might be adopted could rapidly change.