Modeling drug-resistant tuberculosis amplification rates and intervention strategies in Bangladesh

Kuddus, Md Abdul, Meehan, Michael T., White, Lisa J., McBryde, Emma S., and Adekunle, Adeshina I. (2020) Modeling drug-resistant tuberculosis amplification rates and intervention strategies in Bangladesh. PLoS ONE, 15 (7). e0236112.

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Abstract

Tuberculosis (TB) is the seventh leading cause of morbidity and mortality in Bangladesh. Although the National TB control program (NTP) of Bangladesh is implementing its nationwide TB control strategies, more specific and effective single or combination interventions are needed to control drug-susceptible (DS) and multi-drug resistant (MDR) TB. In this study, we developed a two strain TB mathematical model with amplification and fit it to the Bangladesh TB data to understand the transmission dynamics of DS and MDR TB. Sensitivity analysis was used to identify important parameters. We evaluated the cost-effectiveness of varying combinations of four basic control strategies including distancing, latent case finding, case holding and active case finding, all within the optimal control framework. From our fitting, the model with different transmission rates between DS and MDR TB best captured the Bangladesh TB reported case counts. The estimated basic reproduction number for DS TB was 1.14 and for MDR TB was 0.54, with an amplification rate of 0.011 per year. The sensitivity analysis also indicated that the transmission rates for both DS and MDR TB had the largest influence on prevalence. To reduce the burden of TB (both DS and MDR), our finding suggested that a quadruple control strategy that combines distancing control, latent case finding, case holding and active case finding is the most cost-effective. Alternative strategies can be adopted to curb TB depending on availability of resources and policy makers’ decisions.

Item ID: 64752
Item Type: Article (Research - C1)
ISSN: 1932-6203
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Copyright Information: ©2020 Kuddus et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Additional Information:

A version of this publication was included as Chapter 6 of the following PhD thesis: Kuddus, Md Abdul (2021) Using mathematical models to develop tuberculosis control strategies in Bangladesh. PhD thesis, James Cook University, which is available Open Access in ResearchOnline@JCU. Please see the Related URLs for access.

Funders: James Cook University (JCU)
Projects and Grants: JCU-QLD-835481
Date Deposited: 06 Jan 2021 22:55
FoR Codes: 42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 100%
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