Tuberculosis control interventions targeted to previously treated people in a high-incidence setting: a modelling...

Area of Science:

• Public Health
• Epidemiology
• Infectious Disease Modeling

Background:

• Recurrent tuberculosis significantly contributes to disease burden in high-incidence settings.
• Interventions for previously treated individuals are crucial for effective tuberculosis control.
• The population-level impact of targeted interventions for this group remains understudied.

Purpose of the Study:

• To project the population-level effect of tuberculosis control interventions.
• To evaluate strategies targeting individuals with a history of previous tuberculosis treatment.
• To assess impact in a high-incidence setting.

Main Methods:

• Developed a transmission-dynamic model for tuberculosis and HIV.
• Calibrated the model to demographic, prevalence, and treatment outcome data from Cape Town, South Africa.
• Projected effects of annual targeted active case finding and isoniazid preventive therapy over 10 years.

Main Results:

• Current control efforts project a slow decline in tuberculosis incidence.
• Targeted active case finding combined with secondary isoniazid preventive therapy could avert 40% of incident cases.
• This strategy could avert 41% of tuberculosis deaths between 2016 and 2025.

Conclusions:

• Targeted interventions for previously treated individuals can accelerate tuberculosis morbidity and mortality reduction.
• Active case finding and isoniazid preventive therapy show significant potential in high-incidence settings.
• Further studies on cost and resource implications are needed for feasibility assessment.