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Modelling tuberculosis trends in the USA

  • A. N. HILL (a1), J. E. BECERRA (a1) and K. G. CASTRO (a1)

We present a mathematical transmission model of tuberculosis in the USA. The model is calibrated to recent trends of declining incidence in the US-born and foreign-born populations and is used in assessing relative impacts of treatment of latently infected individuals on elimination time, where elimination is defined as annual incidence <1 case/million. Provided current control efforts are maintained, elimination in the US-born population can be achieved before the end of this century. However, elimination in the foreign-born population is unlikely in this timeframe even with higher rates of targeted testing and treatment of residents of and immigrants to the USA with latent tuberculosis infection. Cutting transmission of disease as an interim step would shorten the time to elimination in the US-born population but foreign-born rates would remain above the elimination target.

Corresponding author
*Author for correspondence: Dr A. N. Hill, Division of Tuberculosis Elimination, U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-10, Atlanta, GA 30333, USA. (Email:
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5. C Colijn , T Cohen , M Murray . Mathematical models of tuberculosis: accomplishments and future challenges. In: RP Mondaini , R Dilão , eds. BIOMAT 2006: International Symposium on Mathematical and Computational Biology. Singapore: World Scientific, 2007, p. 123.

7. C Dye , Prospects for worldwide tuberculosis control under the WHO DOTS strategy. Directly observed short-course therapy. Lancet 1998; 352: 18861891.

10. E Vynnycky , PEM Fine . The long-term dynamics of tuberculosis and other diseases with long serial intervals: implications of and for changing reproduction numbers. Epidemiology and Infection 1998; 121: 309324.

11. E Vynnycky , PEM Fine . Interpreting the decline in tuberculosis: the role of secular trends in effective contact. International Journal of Epidemiology 1999; 28: 327334.

12. E Ziv , CL Daley , SM Blower . Early therapy for latent tuberculosis infection. American Journal of Epidemiology 2001; 153: 381385.

14. C Colijn , T Cohen , M Murray . Emergent heterogeneity in declining tuberculosis epidemics. Journal of Theoretical Biology 2007; 247: 765774.

15. C Dye , BG Williams . Eliminating human tuberculosis in the twenty-first century. Journal of the Royal Society Interface 2008; 5: 653662.

16. Z-W Jia , Modeling the impact of immigration on the epidemiology of tuberculosis. Theoretical Population Biology 2008; 73: 437448.

18. LJ Abu-Raddad , Epidemiological benefits of more-effective tuberculosis vaccines, drugs, and diagnostics. Proceedings of the National Academy of Sciences USA 2009; 106: 13 98013 985.

21. DE Bennett , Prevalence of tuberculosis infection in the United States population. The National Health and Nutrition Examination Survey, 1999–2000. American Journal of Respiratory and Critical Care Medicine 2008; 177: 348355.

22. SM Blower , H Dowlatabadi . Sensitivity and uncertainty analysis of complex models of disease transmission: an HIV model, as an example. International Statistical Review 1994; 62: 229243.

23. MA Sanchez , SM Blower . Uncertainty and sensitivity analysis of the basic reproductive rate. Tuberculosis as an example. American Journal of Epidemiology 1997; 145: 11271137.

25. LR Petzold . Automatic selection of methods for solving stiff and nonstiff systems of ordinary differential equations. SIAM Journal on Scientific and Statistical Computing 1983; 4: 136148.

27. F Brauer , P van den Driessche . Models for transmission of disease with immigration of infectives. Mathematical Biosciences 2001; 171: 143154.

31. PM Small , The epidemiology of tuberculosis in San Francisco – a population-based study using conventional and molecular methods. New England Journal of Medicine 1994; 330: 17031709.

33. C Dye , BG Williams . Slow elimination of multidrug-resistant tuberculosis. Science Translational Medicine 2009; 1: 3ra8.

37. TM Daniel , SM Debanne . Estimation of the annual risk of tuberculous infection for white men in the United States. Journal of Infectious Diseases 1997; 175: 15351537.

38. TR Sterling , The scope and impact of treatment of latent tuberculosis infection in the United States and Canada. American Journal of Respiratory and Critical Care Medicine 2006; 173: 927931.

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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
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