Assortative social mixing and sex disparities in tuberculosis burden

Autor: Richard J. Hayes, Peter J. Dodd, Debebe Shaweno, Katherine C. Horton
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
Scientific Reports
ISSN: 2045-2322
Popis: Globally, men have higher tuberculosis (TB) burden but the mechanisms underlying this sex disparity are not fully understood. Recent surveys of social mixing patterns have established moderate preferential within-sex mixing in many settings. This assortative mixing could amplify differences from other causes. We explored the impact of assortative mixing and factors differentially affecting disease progression and detection using a sex-stratified deterministic TB transmission model. We explored the influence of assortativity at disease-free and endemic equilibria, finding stronger effects during invasion and on increasing male:female prevalence (M:F) ratios than overall prevalence. Variance-based sensitivity analysis of endemic equilibria identified differential progression as the most important driver of M:F ratio uncertainty. We fitted our model to prevalence and notification data in examplar settings within a fully Bayesian framework. For our high M:F setting, random mixing reduced equilibrium M:F ratios by 12%(95%CrI 0 - 30%). Equalizing male case detection there led to a 20% (95%CrI 11 - 31%) reduction in M:F ratio over 10 years - insufficient to eliminate sex disparities. However, this potentially achievable improvement was associated with a meaningful 8%(95%CrI 4 - 14%) reduction in total TB prevalence over this time frame.
Databáze: OpenAIRE
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