The goal of this project is to develop a transmission model of tuberculosis in the United States capable of assessing the likely impact, costs, and cost-effectiveness of certain interventions at the population level.
A key outcome from the perspective of TB control in the United States is time to elimination, elimination being defined as annual incidence less than one case per million population. While TB incidence in the U.S. has mostly been in decline for several decades, elimination is many years away. Simple statistical extrapolations to calculate years until elimination mask important dynamics of transmission, such as the effects of high risk populations and immigration. The mechanistic interplays between different types of risk, different available interventions, and transmission/achievement of elimination cannot easily be represented in statistical models or simple models that do not account for transmission dynamics.
Our model will build on previous models with elaborated detail on population characteristics (such as age), aspects of TB natural history and epidemiology (including drug resistance), and a refined approach to calibrating the model to observed epidemiologic data. We expect that our model will inform guidelines on detection and treatment of active cases as well as interventions on the prevalence and outcomes of latent infection to change the trajectory of the TB epidemic in the U.S.
Results from this model were presented at The Union North America Region and the National Tuberculosis Controllers Association Joint 20th Annual Conference in Denver, CO, in February 2016. The poster can be viewed here.