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Open Access Estimating tuberculosis incidence from primary survey data: a mathematical modeling approach

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BACKGROUND: There is an urgent need for improved estimations of the burden of tuberculosis (TB).

OBJECTIVE: To develop a new quantitative method based on mathematical modelling, and to demonstrate its application to TB in India.

DESIGN: We developed a simple model of TB transmission dynamics to estimate the annual incidence of TB disease from the annual risk of tuberculous infection and prevalence of smear-positive TB. We first compared model estimates for annual infections per smear-positive TB case using previous empirical estimates from China, Korea and the Philippines. We then applied the model to estimate TB incidence in India, stratified by urban and rural settings.

RESULTS: Study model estimates show agreement with previous empirical estimates. Applied to India, the model suggests an annual incidence of smear-positive TB of 89.8 per 100 000 population (95%CI 56.8–156.3). Results show differences in urban and rural TB: while an urban TB case infects more individuals per year, a rural TB case remains infectious for appreciably longer, suggesting the need for interventions tailored to these different settings.

CONCLUSIONS: Simple models of TB transmission, in conjunction with necessary data, can offer approaches to burden estimation that complement those currently being used.
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Keywords: ARTI; duration; prevalence; transmission

Document Type: Research Article

Affiliations: 1: Public Health Foundation of India, New Delhi, India 2: Epidemiology and Research Division, National Tuberculosis Institute, Bangalore, India 3: Public Health Foundation of India, New Delhi, India; Center for Disease Dynamics, Economics & Policy, Washington, DC, USA; Princeton Environmental Institute, Princeton, New Jersey, USA 4: Public Health Foundation of India, New Delhi, India; Department of Infectious Disease Epidemiology, Imperial College London, London, UK

Publication date: 2017-04-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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