Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis

Background: Household contacts of people with pulmonary tuberculosis (TB) have greater risk of developing TB. Recent guidelines conditionally recommended TB preventive treatment (TPT) for household contacts of any age living in TB high-incidence countries, expanding earlier guidance to provide TPT t...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Jennifer M. Ross, MD, Yongquan Xie, MS, Yaqi Wang, MS, James K. Collins, BS, Cody Horst, MPH, Jessie B. Doody, BA, Paulina Lindstedt, MPH, Jorge R. Ledesma, MPH, Adrienne E. Shapiro, PhD, Prof. Simon I. Hay, FMedSci, Hmwe H. Kyu, PhD, Abraham D. Flaxman, PhD
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://doaj.org/article/25d1cc1484a14152a547fbc809a5e30a
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:25d1cc1484a14152a547fbc809a5e30a
record_format dspace
spelling oai:doaj.org-article:25d1cc1484a14152a547fbc809a5e30a2021-11-24T04:33:18ZEstimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis2589-537010.1016/j.eclinm.2021.101206https://doaj.org/article/25d1cc1484a14152a547fbc809a5e30a2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2589537021004879https://doaj.org/toc/2589-5370Background: Household contacts of people with pulmonary tuberculosis (TB) have greater risk of developing TB. Recent guidelines conditionally recommended TB preventive treatment (TPT) for household contacts of any age living in TB high-incidence countries, expanding earlier guidance to provide TPT to household contacts under five. The all-age population of household contacts has not been estimated. Methods: Our model-based estimation included 20 countries with >80% of incident TB globally in 2019. We developed country-specific distributions of household composition by age and sex using bootstrap resampling from health surveys and census data. We incorporated age-, sex-, year-, and location-specific estimates of pulmonary TB incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the population in each country sharing a household with someone with incident pulmonary TB, and quantified uncertainty using a Monte Carlo approach. Findings: We estimate that 38 million [95% uncertainty interval (UI) 33- 43 million] individuals lived in a household with someone with incident pulmonary TB in 2019 in these 20 countries. Children under five made up 12% of the population with household exposure, while adults were 65%. Zimbabwe, Mozambique, Zambia, and Pakistan had the highest proportion of the population with household exposure, while India had the highest number of contacts (11·4 million, 95% UI 9·7-13·4 million). Interpretation: Expanding TPT evaluation to household contacts of all ages in high-incidence countries could include a population more than 7-times larger than the under-5 contacts previously prioritized. This would substantially increase the impact of household contact investigation on reducing TB morbidity and mortality. Funding: JMR is supported by the National Institute of Allergy and Infectious Diseases (K01 AI138620). This research was funded in part by a 2020 developmental grant from the University of Washington / Fred Hutch Center for AIDS Research, an NIH funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK. This work was funded in part by the National Science Foundation (DMS-1839116).Jennifer M. Ross, MDYongquan Xie, MSYaqi Wang, MSJames K. Collins, BSCody Horst, MPHJessie B. Doody, BAPaulina Lindstedt, MPHJorge R. Ledesma, MPHAdrienne E. Shapiro, PhDProf. Simon I. Hay, FMedSciHmwe H. Kyu, PhDAbraham D. Flaxman, PhDElsevierarticleMedicine (General)R5-920ENEClinicalMedicine, Vol 42, Iss , Pp 101206- (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine (General)
R5-920
spellingShingle Medicine (General)
R5-920
Jennifer M. Ross, MD
Yongquan Xie, MS
Yaqi Wang, MS
James K. Collins, BS
Cody Horst, MPH
Jessie B. Doody, BA
Paulina Lindstedt, MPH
Jorge R. Ledesma, MPH
Adrienne E. Shapiro, PhD
Prof. Simon I. Hay, FMedSci
Hmwe H. Kyu, PhD
Abraham D. Flaxman, PhD
Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
description Background: Household contacts of people with pulmonary tuberculosis (TB) have greater risk of developing TB. Recent guidelines conditionally recommended TB preventive treatment (TPT) for household contacts of any age living in TB high-incidence countries, expanding earlier guidance to provide TPT to household contacts under five. The all-age population of household contacts has not been estimated. Methods: Our model-based estimation included 20 countries with >80% of incident TB globally in 2019. We developed country-specific distributions of household composition by age and sex using bootstrap resampling from health surveys and census data. We incorporated age-, sex-, year-, and location-specific estimates of pulmonary TB incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the population in each country sharing a household with someone with incident pulmonary TB, and quantified uncertainty using a Monte Carlo approach. Findings: We estimate that 38 million [95% uncertainty interval (UI) 33- 43 million] individuals lived in a household with someone with incident pulmonary TB in 2019 in these 20 countries. Children under five made up 12% of the population with household exposure, while adults were 65%. Zimbabwe, Mozambique, Zambia, and Pakistan had the highest proportion of the population with household exposure, while India had the highest number of contacts (11·4 million, 95% UI 9·7-13·4 million). Interpretation: Expanding TPT evaluation to household contacts of all ages in high-incidence countries could include a population more than 7-times larger than the under-5 contacts previously prioritized. This would substantially increase the impact of household contact investigation on reducing TB morbidity and mortality. Funding: JMR is supported by the National Institute of Allergy and Infectious Diseases (K01 AI138620). This research was funded in part by a 2020 developmental grant from the University of Washington / Fred Hutch Center for AIDS Research, an NIH funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK. This work was funded in part by the National Science Foundation (DMS-1839116).
format article
author Jennifer M. Ross, MD
Yongquan Xie, MS
Yaqi Wang, MS
James K. Collins, BS
Cody Horst, MPH
Jessie B. Doody, BA
Paulina Lindstedt, MPH
Jorge R. Ledesma, MPH
Adrienne E. Shapiro, PhD
Prof. Simon I. Hay, FMedSci
Hmwe H. Kyu, PhD
Abraham D. Flaxman, PhD
author_facet Jennifer M. Ross, MD
Yongquan Xie, MS
Yaqi Wang, MS
James K. Collins, BS
Cody Horst, MPH
Jessie B. Doody, BA
Paulina Lindstedt, MPH
Jorge R. Ledesma, MPH
Adrienne E. Shapiro, PhD
Prof. Simon I. Hay, FMedSci
Hmwe H. Kyu, PhD
Abraham D. Flaxman, PhD
author_sort Jennifer M. Ross, MD
title Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
title_short Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
title_full Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
title_fullStr Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
title_full_unstemmed Estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
title_sort estimating the population at high risk for tuberculosis through household exposure in high-incidence countries: a model-based analysis
publisher Elsevier
publishDate 2021
url https://doaj.org/article/25d1cc1484a14152a547fbc809a5e30a
work_keys_str_mv AT jennifermrossmd estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT yongquanxiems estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT yaqiwangms estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT jameskcollinsbs estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT codyhorstmph estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT jessiebdoodyba estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT paulinalindstedtmph estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT jorgerledesmamph estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT adrienneeshapirophd estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT profsimonihayfmedsci estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT hmwehkyuphd estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
AT abrahamdflaxmanphd estimatingthepopulationathighriskfortuberculosisthroughhouseholdexposureinhighincidencecountriesamodelbasedanalysis
_version_ 1718415964364603392