Impact and Effectiveness of State-Level Tuberculosis Interventions in California, Florida, New York, and Texas: A Model-Based Analysis
| Autor: | Sue Reynolds, Sarah T. Cherng, Suzanne M. Marks, Andrew N. Hill, Michael Lauzardo, Sourya Shrestha, Adam Readhead, Margaret J. Oxtoby, Tom Privett, David W. Dowdy, Jennifer Flood, Pennan M. Barry |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Tuberculosis
Epidemiology Original Contributions Psychological intervention Human immunodeficiency virus (HIV) Adult population New York medicine.disease_cause California law.invention 03 medical and health sciences 0302 clinical medicine law Risk Factors Active tb medicine Humans 030212 general & internal medicine Contact Investigation business.industry Incidence (epidemiology) Incidence Models Theoretical medicine.disease Texas United States Transmission (mechanics) 030228 respiratory system Florida Contact Tracing business Demography |
| Zdroj: | Am J Epidemiol |
| Popis: | The incidence of tuberculosis (TB) in the United States has stabilized, and additional interventions are needed to make progress toward TB elimination. However, the impact of such interventions depends on local demography and the heterogeneity of populations at risk. Using state-level individual-based TB transmission models calibrated to California, Florida, New York, and Texas, we modeled 2 TB interventions: 1) increased targeted testing and treatment (TTT) of high-risk populations, including people who are non–US-born, diabetic, human immunodeficiency virus (HIV)-positive, homeless, or incarcerated; and 2) enhanced contact investigation (ECI) for contacts of TB patients, including higher completion of preventive therapy. For each intervention, we projected reductions in active TB incidence over 10 years (2016–2026) and numbers needed to screen and treat in order to avert 1 case. We estimated that TTT delivered to half of the non–US-born adult population could lower TB incidence by 19.8%–26.7% over a 10-year period. TTT delivered to smaller populations with higher TB risk (e.g., HIV-positive persons, homeless persons) and ECI were generally more efficient but had less overall impact on incidence. TTT targeted to smaller, highest-risk populations and ECI can be highly efficient; however, major reductions in incidence will only be achieved by also targeting larger, moderate-risk populations. Ultimately, to eliminate TB in the United States, a combination of these approaches will be necessary. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|