Mieghan Bruce

This study, carried out in 2022–2023, quantified the financial burden of disease in cattle, sheep and goats in Ethiopia for the year 2021 using the animal health loss envelope (AHLE) metric. The AHLE measures all cause disease burden, avoidable and non-avoidable, as the difference in the financial performance of a livestock production system (e.g., gross margin) comparing a scenario where animals are in an ideal state of health to the current situation. A stochastic dynamic population model (DPM) was employed to calculate the gross margin for an average farm and for the national herd under these current and ideal health scenarios. Data for parametrizing the DPM were derived from secondary sources and expert elicitation. The stochastic DPM was simulated for 10,000 iterations and results are reported as means with 95 % percentile intervals (PI). The annual AHLE per average farm was estimated at USD 1209 (95 %PI:392–2470) in cattle, USD 158 (95 %PI:66–292) in sheep and USD 416 (95 %PI:136–847) in goats. At national level, the annual AHLE in ruminants was USD 18.39 billion with USD 15.42 billion (95 % PI:12.70–18.57) in cattle, USD 1.04 billion (95 % PI:0.84–1.30) in sheep, and USD 1.93 billion (95 % PI:1.64–2.25) in goats. Morbidity losses constituted the largest component of the AHLE, exceeding 50 % across all species, while animal health expenditure represented the smallest component, accounting for less than 2 % of AHLE in all species. This high disease burden, with minimal contribution from animal health expenditure, indicates significant opportunity for improvement through investment in animal health.

Bovine mastitis remains one of the most widespread and economically significant diseases affecting the dairy sector in Pakistan. Despite being a leading global milk producer, Pakistan’s dairy industry faces persistent challenges in controlling mastitis, particularly among smallholder farmers with limited access to veterinary care and diagnostic tools. Antibiotics are frequently used to manage mastitis, often without veterinary oversight, contributing to the growing concern of antimicrobial resistance (AMR). The widespread presence of
Staphylococcus aureus
, a biofilm-forming pathogen, further complicates treatment and accelerates resistance development. Pakistan has initiated efforts to address AMR through national action plans. However, gaps remain in surveillance, responsible antibiotic use, and access to affordable alternatives. This review examines the current landscape of bovine mastitis in Pakistan, including its epidemiology, economic impact, therapeutic practices, and AMR trends. It also outlines practical, low-cost recommendations for improving mastitis management and reducing inappropriate use of antibiotics, particularly in rural settings. Addressing these interconnected challenges through locally adapted, sustainable approaches is essential for improving animal health, milk safety, and long-term productivity in Pakistan’s dairy sector, whilst addressing the global challenge of AMR.

Naturally occurring hypercortisolism in dogs is commonly investigated in primary care practice. However, there is a poor understanding of the preference and interpretation of diagnostic tests by Australian veterinarians. This study aimed to investigate the diagnostic processes used by Australian primary care veterinarians via an anonymous online survey consisting of multiple-choice and short-answer questions. The survey was completed by 399 respondents. When hypercortisolism was suspected, 392 performed adrenal function testing, while seven used treatment trials. With consistent clinical signs but no clinicopathological abnormalities, 354 performed screening tests, and 312 in dogs with consistent clinicopathological abnormalities but no clinical signs. For veterinarians who performed function testing, 296 used the same screening tests regardless of the magnitude of pre-test suspicion; 266 used either an adrenocorticotropic hormone (ACTH) stimulation test or low-dose dexamethasone suppression test (LDDST) alone. Even in the absence of financial constraints, 158 of 399 respondents almost never attempted differentiation between ACTH-dependent and ACTH-independent disease. For those attempting differentiation, 178 used abdominal ultrasound and 102 used LDDST. Approximately half of all respondents indicated that specialist referral was not offered to any of the preceding 10 cases suspected of hypercortisolism. Hypercortisolism is frequently diagnosed in dogs without consistent clinical signs or without performing routine clinical pathology tests, raising concerns for overdiagnosis. A large proportion of respondents rarely attempted to differentiate between causes of hypercortisolism, possibly affecting long-term management and prognosis. Referral to a specialist is rare, suggesting the condition is predominantly managed in primary care practice.

This study aims to analyse the crowding-out and crowding-in effects of non-communicable diseases (NCDs) related out-of-pocket (OOP) health expenditures on household consumption in Bangladesh.

Design
This study used data from the nationally representative Bangladesh household income and expenditure survey (HIES) 2022.

Setting
Eight divisions of Bangladesh.

Participants
14 395 households.

Primary and secondary outcome measures
We examined how household consumption patterns across 20 expenditure categories were impacted by OOP health spending for NCD management, with a focus on income-level disparities.

Results
In Bangladesh, OOP health expenditures for NCDs crowded out household expenditures on essential items like food and rent. Across all households, OOP health expenditures for NCDs by 10 US$ crowded out −3.8 US$ of expenditure on food (95% CI −5.1 to –2.5), and more specifically on protein-rich foods (−2.0 US$, 95% CI −2.8 to –1.2), spices (−0.2 US$, 95% CI −0.3 to –0.1), and restaurant and café meals (−0.9 US$, 95% CI −1.4 to –0.5). Crowding-out was also seen for tobacco, rent, durable goods and miscellaneous. In lower-income households, expenditures on food (−4.1 US$, 95% CI −7.2 to –1.1), restaurant and café meals (−2.0 US$, 95% CI −3.1 to –0.8), spices (−0.4 US$, 95% CI −0.7 to –0.09), and rent (−3.1 US$, 95% CI −4.5 to –1.6) were significantly crowded out.

Conclusion
This research demonstrates that NCD-related spending in Bangladesh reduces budgets for both food and non-food expenditures, with a stronger crowding-out effect on food items and rent, particularly in lower-income households. Effective financial and social protection mechanisms against NCDs are warranted to safeguard the consumption of the NCD-affected households in Bangladesh.

Context
Links between tapir health and environmental conditions are well-established, but substantial knowledge gaps on biological and environmental causes of ill-health remain. Furthermore, anthropogenic impacts and climate change effects on disease patterns are escalating issues.

Aims
Our study aimed to build on earlier research on wild lowland tapir (Tapirus terrestris) health and investigate risk factors and potential consequences associated with infectious agents.

Methods
Between 2008 and 2018, 174 samples from 115 wild lowland tapirs across two contrasting locations in Brazil were screened for four infectious agents (bluetongue virus, porcine parvovirus, Leptospira interrogans serovar Pomona, and Trypanosoma terrestris), along with clinical and haematological findings. Generalised linear models and boosted regression trees were applied to evaluate associations with risk factors, likely disease consequences, and meteorological conditions.

Key results
Tapirs in human-modified areas presented higher risk of exposure to livestock pathogens such as bluetongue virus (relative influence (RI) 94.2%) and porcine parvovirus (RI 58.5%), whereas those in pristine habitats exhibited higher risk to Trypanosoma terrestris (RI 92.5%) and Leptospira sp. (RI 39.9%). Bluetongue cases increased from one in Year 2 to 35 in Year 10 (odds ratio 2.90, 95% CI 2.12–3.97, P < 0.001). Significant associations were found between infectious agents and pale mucous membranes (RI 85.5%), high tick burden (RI 78.4%), low red (RI 78.3%) and high white (RI 38.1%) blood cell counts, and presence of wounds (RI 59.1%). Poor body condition was weakly linked to all variables. Elevated alkaline phosphatase, glucose, and total protein levels demonstrated associations with infectious agents, whereas high creatine kinase was linked to capture-related stress. No significant associations with meteorological data were detected.

Conclusions
Our study highlighted the complex influence of biological and environmental conditions on infectious disease dynamics in tapirs. Location emerged as the main risk factor for pathogen occurrence, with biomarkers such as heavy tick burden, pale mucous membranes, presence of wounds, high white blood cell count, and low red blood cell count representing key indicators of tapir health.

Implications
Our research has provided robust scientific evidence addressing long-standing hypotheses on tapir health, supporting practical applications and informing wildlife management and disease surveillance research.

Thiafentanil is a popular opioid agonist used for wildlife chemical immobilisation. Its effects are quickly and completely reversed by the antagonist naltrexone. Successful wildlife immobilisations using thiafentanil have been documented in a variety of wildlife species globally. The aim of this study was to describe the single‐dose intramuscular (IM) and intravenous (IV) pharmacokinetics of thiafentanil in goats at a dose of 90 μg/kg using a single cross‐over study. The IM dose was administered in the left Vastus lateralis. Plasma samples were collected up to 120 min after thiafentanil administration from two female and eight male adult goats. Samples were analysed by liquid chromatography–tandem mass spectrometry (LC–MS/MS). Pharmacokinetic parameters from one and two‐compartment models were estimated via a Bayesian approach. The two‐compartment model was preferred overall. The estimated bioavailability was 0.677 (90% Crl: 0.542–0.888), absorption rate constant ( k a ) was 0.058 1/min (90% Crl: 0.045–0.115) and clearance was 29.0 mL/min/kg (90% Crl: 23.7–36.3) from this model. This study provides key pharmacokinetic data on thiafentanil, supporting a two‐compartment model and offering insights into its absorption, bioavailability, and clearance when used for wildlife immobilisation.

Clostridioides difficile is a known cause of diarrhea and colitis in human and non-human animals. While C. difficile is regularly isolated from domesticated horses, little is known about its prevalence in wild or feral populations. In Australia, the horse population encompasses a mix of both domesticated and feral animals, with the feral population of 400,000 estimated to be the largest in the world. This study investigated the presence and characteristics of C. difficile in Australian feral horses and evaluated their potential as a source or reservoir of C. difficile in the wider community. Fecal samples (n = 380) were collected from free-roaming feral horses from five Australian jurisdictions and cultured for C. difficile. Isolates were characterized by PCR ribotyping and toxin profiling. Antimicrobial susceptibility testing was performed for fidaxomicin, vancomycin, metronidazole, rifaximin, clindamycin, erythromycin, amoxicillin-clavulanate, moxifloxacin, meropenem, and tetracycline. C. difficile was isolated from 45 of the 380 samples (11.8%)—one-third of that seen in recent studies on Australian domesticated horses but consistent with wild animal species worldwide. Forty ribotypes (RTs) were identified, 28 of which (70%) were novel; other RTs had been previously reported in humans, livestock, and soils. Eighteen toxigenic C. difficile strains were isolated, of which eight contain binary toxin genes. Strains were largely susceptible to the antimicrobial agents tested. This investigation provides preliminary information on C. difficile in feral horses in Australia and allows a comparison with their domestic counterparts. The findings support the hypothesis that all horse feces represent a potential source of C. difficile in the community.IMPORTANCEClostridioides difficile poses an ongoing threat to healthcare in the community, with increasing evidence of transmission outside the hospital setting. In keeping with a One Health model of dispersion, investigations into this microorganism within the wider environment are vital to understanding this evolving epidemiology. Australia has the biggest population of feral horses in the world, and this study of C. difficile in feral horses provides insight into the role of non-domesticated animals in the dissemination of C. difficile. Examination of prevalence and characterization of isolates provides a baseline for evaluating the effect of antimicrobials and other factors associated with domestication on equine C. difficile infection.

Non-communicable diseases (NCDs) bring double burden of diseases for Bangladesh where public health system is facing challenges to tackle it. Previous studies investigating healthcare utilization by the patients with NCDs lack nationally representative data. The present study examined healthcare utilization and factors associated with utilizing different types of health facilities (public/private/medicine shop /others/multiple providers). This study further tried to find out the linkage between utilizing different types of health facilities and the receipt of at least one lifestyle behaviour or more, and patient-related medication non-adherence.
We analysed nationally representative cross-sectional STEPwise approach to NCD risk factor surveillance (STEPS) Survey 2018 in Bangladesh. Following Andersen's conceptual framework and applying multinomial logistic regression, we examined multiple types of healthcare utilization to estimate and identify predictors associated with the types of healthcare facilities accessed. Further relationships with the receipt of at least one lifestyle behaviour or more, and patient-related medication non-adherence were investigated using binary logistic regression.
The majority of the participants used private facilities (41.0%) for curative care. For accessing medicine for NCDs, participants mostly used medicine shop (81.2%). In the fully adjusted model comparing public facilities vs. medicine shop respondents with no formal education (vs. university education or higher) were more likely to use medicine shop (adjusted relative risk ratio (aRRR):3.9; confidence interval (CI):1.1,13.5). While comparing public facilities vs. other healthcare options (village doctor, alternative medicine practitioner (Homeo, Ayurveda, Unani) and traditional healer), respondents from rural area (vs. urban) more likely to utilize other healthcare options (aRRR: 3.5; CI: 1.8,6.8).
The study findings are crucial for Bangladesh's ongoing effort to strengthen NCDs care. Further elucidation of the factors influencing the decision between types of health facility use could be provided by future mixed-method studies.

The impact of diseases on tapir mortality and potential implications for preventive medicine and conservation remain unclear. A systematic literature review was conducted using seven databases and grey literature to address these gaps. The PRISMA statement was adopted to report results, and boosted regression tree models were employed for data analysis. After screening 5323 records and removing duplicates, the title and abstract of 2484 records were assessed. Out of 502 eligible studies, only 206 met all inclusion criteria. These were published between 1924 and 2023 in ten languages, comprising mainly case reports (45.1 %) and cross-sectional studies (41.3 %). Infectious diseases were found in 72.9 % of the reports, and 27.2 % presented clinical signs. The most affected systems were gastroenteric (22.7 %), integumentary (22.1 %), and respiratory (17.5 %). Respiratory diseases were associated with increased mortality. Factors affecting tapir mortality included species (relative influence 41.5 %), followed by geographic location (23.5 %) and captivity (16.8 %). Clinical signs were the least important variable (4 %). While infectious diseases were associated with higher mortality risk, tapirs were more likely to become ill from non-infectious than infectious diseases. Captive individuals were also more likely to present with illness than their wild counterparts. When considering external causes, vehicle collisions represented the most significant cause of death (52.2 %), followed by hunting (38.2 %). Diseases (8.7 %) were the third most important, with bacterial infections the leading cause of death. This review represents the most comprehensive overview on tapir health to date and provides novel ways to collate epidemiological data from disparate study designs.

Thiafentanil is a µ-opioid agonist used for the chemical immobilisation of a variety of ungulate species and is antagonised by the administration of naltrexone. The potential for these ungulates to be hunted for consumption by humans or predators raises concerns of drug residues in animal tissues. No analytical method to quantify tissue residue concentrations of thiafentanil has been previously reported. This research developed an LC-MS/MS method to quantify thiafentanil in bovine muscle, and both thiafentanil and naltrexone in bovine liver and kidney matrices. The analytical method was applied to quantify tissue residues in samples collected from goats 1, 2, 3, and 6 days post thiafentanil administration. The assay was validated over the calibration range 6.25–200ng/mg for thiafentanil in muscle, and 3.13–400ng/mg for thiafentanil and 57.8–7400ng/mg for naltrexone in liver and kidney. No residues above the lowest limit of quantification were detected in the injection site, longissimus dorsi muscle, liver or kidney samples collected from the goats. The reported analytical method and residue depletion data provide a foundation for future thiafentanil and naltrexone residue depletion studies in wildlife species.