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An evaluation of the efficacy of tub...

Guwatudde, David.

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An evaluation of the efficacy of tuberculosis control interventions in high burden countries using mathematical modeling: A case study in Uganda.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	An evaluation of the efficacy of tuberculosis control interventions in high burden countries using mathematical modeling: A case study in Uganda./
作者:	Guwatudde, David.
面頁冊數:	225 p.
附註:	Source: Dissertation Abstracts International, Volume: 64-07, Section: B, page: 3032.
Contained By:	Dissertation Abstracts International64-07B.
標題:	Biology, Biostatistics. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3100007

An evaluation of the efficacy of tuberculosis control interventions in high burden countries using mathematical modeling: A case study in Uganda.
Guwatudde, David.

An evaluation of the efficacy of tuberculosis control interventions in high burden countries using mathematical modeling: A case study in Uganda. - 225 p.

Source: Dissertation Abstracts International, Volume: 64-07, Section: B, page: 3032.

Thesis (Ph.D.)--Case Western Reserve University (Health Sciences), 2003.

Tuberculosis remains a major public health problem in many parts of sub-Saharan Africa where the burden of tuberculosis continues to increase. This is widely believed to be due to the Human Immunodeficiency Virus (HIV) epidemic and poor public health infrastructure in most of these countries. Current tuberculosis control efforts have been devoted to improving case detection and treatment cure rates. The relative efficacy of other interventions including BCG vaccination, tuberculosis preventive therapy, and the link between control of HIV infection and its impact on tuberculosis at a population level in sub-Saharan Africa is not clear.Subjects--Topical Terms:

1018416
Biology, Biostatistics.

An evaluation of the efficacy of tuberculosis control interventions in high burden countries using mathematical modeling: A case study in Uganda.
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520 $a Tuberculosis remains a major public health problem in many parts of sub-Saharan Africa where the burden of tuberculosis continues to increase. This is widely believed to be due to the Human Immunodeficiency Virus (HIV) epidemic and poor public health infrastructure in most of these countries. Current tuberculosis control efforts have been devoted to improving case detection and treatment cure rates. The relative efficacy of other interventions including BCG vaccination, tuberculosis preventive therapy, and the link between control of HIV infection and its impact on tuberculosis at a population level in sub-Saharan Africa is not clear.
520 $a Building on mathematical models for tuberculosis transmission developed by previous investigators, a model relevant for the sub-Saharan African setting is developed and used to evaluate the efficacy of various tuberculosis control interventions using Uganda as a case study. Sensitivity analysis is used to examine how the impact of these interventions might be affected in the different settings of sub-Saharan Africa. Model simulations show that: (a) Improving BCG vaccination coverage beyond 60% will lead to a very small, and slow impact on tuberculosis in the population. (b) If 25% of latently infected HIV-positive persons receive tuberculosis preventive therapy, there will be a reduction in tuberculosis of only 6.8% in the population in twenty years. This effect is much less than that suggested by previous investigators. A large proportion of latently infected HIV-positive persons need to receive the intervention to have a substantial reduction in tuberculosis. (c) Improving case detection and treatment cure rates each independently have a quick and substantial impact on reducing tuberculosis in the population. The impact of improving the case detection rate on tuberculosis is however highly sensitive to the baseline prevalence of HIV infection. (d) It would take decades to eliminate tuberculosis in these populations because of high levels of latent tuberculosis infection. A strategy that initially invests resources to improve highly efficacious interventions like case detection and treatment cure rates, followed later by preventive therapy to reduce LTB infection in the population is useful as a long-term effort to significantly reduce the burden of tuberculosis in these populations.
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