Comparison of Two Rift Valley Fever Serological Tests in Cameroonian Cattle Populations Using a Bayesian Latent Class Approach

Rift Valley Fever is an important zoonotic viral disease of livestock occurring across much of Africa causing acute febrile illness, abortion, and neonatal death in livestock particularly sheep and cattle and a range of disease in humans from mild flu-like symptoms to more severe haemorrhagic fever and death. Understanding the epidemiology requires well-evaluated tools including antibody detection ELISAs. It is well-recognized that tests developed in one population do not necessarily perform as well when used in different populations and it is therefore important to assess tests in the populations in which they are to be used. Here we describe the performance of a commercial RVF ELISA (ID. Vet) and an in-house plaque reduction neutralization test (PRNT80). A Bayesian no gold standard latent class model for two tests and >= 2 populations based on the Hui-Walter model was used to estimate the test parameters using a range of populations based on geographical separation and age to assess consistency of performance across different sub-populations. The ID. Vet ELISA had an estimated diagnostic sensitivity (Se) of 0.854 (0.655-0.991 95% BCI) and specificity (Sp) of 0.986 (0.971-0.998 95% BCI) using all the data and splitting the population by geographical region compared to 0.844 (0.660-0.973 95% BCI) and 0.981 (0.965-0.996 95% BCI) for the PRNT80. There was slight variation in the mean Se and Sp in different sub-populations mainly in Se estimates due to small numbers of positives in the sub-populations but the 95% BCI generally overlapped suggesting a very consistent performance across the different geographical areas and ages of animals. This is one of few reports of serological evidence of RVF in Central Africa and strongly suggests the virus is actively circulating in this cattle population. This has important public health implications and RVF should be considered as a differential in both livestock disease cases as well as human febrile cases in West and Central Africa not just East Africa. We also demonstrate that the performance of the commercial ELISA is comparable to the PRNT80 but has the advantages of speed, lower cost and no containment needs making it a much more useful test for low and middle income settings (LMICs).