Assortative social mixing and sex disparities in tuberculosis burden

Abstract 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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Debebe Shaweno, Katherine C. Horton, Richard J. Hayes, Peter J. Dodd
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4fdb3e1d942d489b8ea58008923d2a0d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:4fdb3e1d942d489b8ea58008923d2a0d
record_format	dspace
spelling	oai:doaj.org-article:4fdb3e1d942d489b8ea58008923d2a0d2021-12-02T18:15:45ZAssortative social mixing and sex disparities in tuberculosis burden10.1038/s41598-021-86869-w2045-2322https://doaj.org/article/4fdb3e1d942d489b8ea58008923d2a0d2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86869-whttps://doaj.org/toc/2045-2322Abstract 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 exemplar 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.Debebe ShawenoKatherine C. HortonRichard J. HayesPeter J. DoddNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Debebe Shaweno Katherine C. Horton Richard J. Hayes Peter J. Dodd Assortative social mixing and sex disparities in tuberculosis burden
description	Abstract 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 exemplar 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.
format	article
author	Debebe Shaweno Katherine C. Horton Richard J. Hayes Peter J. Dodd
author_facet	Debebe Shaweno Katherine C. Horton Richard J. Hayes Peter J. Dodd
author_sort	Debebe Shaweno
title	Assortative social mixing and sex disparities in tuberculosis burden
title_short	Assortative social mixing and sex disparities in tuberculosis burden
title_full	Assortative social mixing and sex disparities in tuberculosis burden
title_fullStr	Assortative social mixing and sex disparities in tuberculosis burden
title_full_unstemmed	Assortative social mixing and sex disparities in tuberculosis burden
title_sort	assortative social mixing and sex disparities in tuberculosis burden
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4fdb3e1d942d489b8ea58008923d2a0d
work_keys_str_mv	AT debebeshaweno assortativesocialmixingandsexdisparitiesintuberculosisburden AT katherinechorton assortativesocialmixingandsexdisparitiesintuberculosisburden AT richardjhayes assortativesocialmixingandsexdisparitiesintuberculosisburden AT peterjdodd assortativesocialmixingandsexdisparitiesintuberculosisburden
_version_	1718378332018442240

Assortative social mixing and sex disparities in tuberculosis burden

Ejemplares similares