Cargando…
The impact of active case finding on transmission dynamics of tuberculosis: A modelling study
BACKGROUND: In the last decade, active case finding (ACF) strategies for tuberculosis (TB) have been implemented in many diverse settings, with some showing large increases in case detection and reporting at the sub-national level. There have also been several studies which seek to provide evidence...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604297/ https://www.ncbi.nlm.nih.gov/pubmed/34797864 http://dx.doi.org/10.1371/journal.pone.0257242 |
_version_ | 1784601927618658304 |
---|---|
author | Ayabina, Diepreye Victoria Gomes, M. Gabriela M. Nguyen, Nhung Viet Vo, Luan Shreshta, Suvesh Thapa, Anil Codlin, Andrew James Mishra, Gokul Caws, Maxine |
author_facet | Ayabina, Diepreye Victoria Gomes, M. Gabriela M. Nguyen, Nhung Viet Vo, Luan Shreshta, Suvesh Thapa, Anil Codlin, Andrew James Mishra, Gokul Caws, Maxine |
author_sort | Ayabina, Diepreye Victoria |
collection | PubMed |
description | BACKGROUND: In the last decade, active case finding (ACF) strategies for tuberculosis (TB) have been implemented in many diverse settings, with some showing large increases in case detection and reporting at the sub-national level. There have also been several studies which seek to provide evidence for the benefits of ACF to individuals and communities in the broader context. However, there remains no quantification of the impact of ACF with regards to reducing the burden of transmission. We sought to address this knowledge gap and quantify the potential impact of active case finding on reducing transmission of TB at the national scale and further, to determine the intensification of intervention efforts required to bring the reproduction number (R(0)) below 1 for TB. METHODS: We adopt a dynamic transmission model that incorporates heterogeneity in risk to TB to assess the impact of an ACF programme (IMPACT TB) on reducing TB incidence in Vietnam and Nepal. We fit the models to country-level incidence data using a Bayesian Markov Chain Monte Carlo approach. We assess the impact of ACF using a parameter in our model, which we term the treatment success rate. Using programmatic data, we estimate how much this parameter has increased as a result of IMPACT TB in the implementation districts of Vietnam and Nepal and quantify additional efforts needed to eliminate transmission of TB in these countries by 2035. RESULTS: Extending the IMPACT TB programme to national coverage would lead to moderate decreases in TB incidence and would not be enough to interrupt transmission by 2035. Decreasing transmission sufficiently to bring the reproduction number (R0) below 1, would require a further intensification of current efforts, even at the sub-national level. CONCLUSIONS: Active case finding programmes are effective in reducing TB in the short term. However, interruption of transmission in high-burden countries, like Vietnam and Nepal, will require comprehensive incremental efforts. Complementary measures to reduce progression from infection to disease, and reactivation of latent infection, are needed to meet the WHO End TB incidence targets. |
format | Online Article Text |
id | pubmed-8604297 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-86042972021-11-20 The impact of active case finding on transmission dynamics of tuberculosis: A modelling study Ayabina, Diepreye Victoria Gomes, M. Gabriela M. Nguyen, Nhung Viet Vo, Luan Shreshta, Suvesh Thapa, Anil Codlin, Andrew James Mishra, Gokul Caws, Maxine PLoS One Research Article BACKGROUND: In the last decade, active case finding (ACF) strategies for tuberculosis (TB) have been implemented in many diverse settings, with some showing large increases in case detection and reporting at the sub-national level. There have also been several studies which seek to provide evidence for the benefits of ACF to individuals and communities in the broader context. However, there remains no quantification of the impact of ACF with regards to reducing the burden of transmission. We sought to address this knowledge gap and quantify the potential impact of active case finding on reducing transmission of TB at the national scale and further, to determine the intensification of intervention efforts required to bring the reproduction number (R(0)) below 1 for TB. METHODS: We adopt a dynamic transmission model that incorporates heterogeneity in risk to TB to assess the impact of an ACF programme (IMPACT TB) on reducing TB incidence in Vietnam and Nepal. We fit the models to country-level incidence data using a Bayesian Markov Chain Monte Carlo approach. We assess the impact of ACF using a parameter in our model, which we term the treatment success rate. Using programmatic data, we estimate how much this parameter has increased as a result of IMPACT TB in the implementation districts of Vietnam and Nepal and quantify additional efforts needed to eliminate transmission of TB in these countries by 2035. RESULTS: Extending the IMPACT TB programme to national coverage would lead to moderate decreases in TB incidence and would not be enough to interrupt transmission by 2035. Decreasing transmission sufficiently to bring the reproduction number (R0) below 1, would require a further intensification of current efforts, even at the sub-national level. CONCLUSIONS: Active case finding programmes are effective in reducing TB in the short term. However, interruption of transmission in high-burden countries, like Vietnam and Nepal, will require comprehensive incremental efforts. Complementary measures to reduce progression from infection to disease, and reactivation of latent infection, are needed to meet the WHO End TB incidence targets. Public Library of Science 2021-11-19 /pmc/articles/PMC8604297/ /pubmed/34797864 http://dx.doi.org/10.1371/journal.pone.0257242 Text en © 2021 Ayabina et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ayabina, Diepreye Victoria Gomes, M. Gabriela M. Nguyen, Nhung Viet Vo, Luan Shreshta, Suvesh Thapa, Anil Codlin, Andrew James Mishra, Gokul Caws, Maxine The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title | The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title_full | The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title_fullStr | The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title_full_unstemmed | The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title_short | The impact of active case finding on transmission dynamics of tuberculosis: A modelling study |
title_sort | impact of active case finding on transmission dynamics of tuberculosis: a modelling study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604297/ https://www.ncbi.nlm.nih.gov/pubmed/34797864 http://dx.doi.org/10.1371/journal.pone.0257242 |
work_keys_str_mv | AT ayabinadiepreyevictoria theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT gomesmgabrielam theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT nguyennhungviet theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT voluan theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT shreshtasuvesh theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT thapaanil theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT codlinandrewjames theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT mishragokul theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT cawsmaxine theimpactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT ayabinadiepreyevictoria impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT gomesmgabrielam impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT nguyennhungviet impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT voluan impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT shreshtasuvesh impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT thapaanil impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT codlinandrewjames impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT mishragokul impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy AT cawsmaxine impactofactivecasefindingontransmissiondynamicsoftuberculosisamodellingstudy |