Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study

Abstract Tuberculosis (TB) is a major public health problem in Bangladesh. Although the National TB control program of Bangladesh is implementing a comprehensive expansion of TB control strategies, logistical challenges exist, and there is significant uncertainty concerning the disease burden. Mathe...

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Autores principales:	Md Abdul Kuddus, Michael T. Meehan, Md. Abu Sayem, Emma S. McBryde
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b1c5e71b0eae42bab6cef66680e5b01e
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spelling	oai:doaj.org-article:b1c5e71b0eae42bab6cef66680e5b01e2021-12-02T16:23:14ZScenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study10.1038/s41598-021-83768-y2045-2322https://doaj.org/article/b1c5e71b0eae42bab6cef66680e5b01e2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83768-yhttps://doaj.org/toc/2045-2322Abstract Tuberculosis (TB) is a major public health problem in Bangladesh. Although the National TB control program of Bangladesh is implementing a comprehensive expansion of TB control strategies, logistical challenges exist, and there is significant uncertainty concerning the disease burden. Mathematical modelling of TB is considered one of the most effective ways to understand the dynamics of infection transmission and allows quantification of parameters in different settings, including Bangladesh. In this study, we present a two-strain mathematical modelling framework to explore the dynamics of drug-susceptible (DS) and multidrug-resistant (MDR) TB in Bangladesh. We calibrated the model using DS and MDR-TB annual incidence data from Bangladesh from years 2001 to 2015. Further, we performed a sensitivity analysis of the model parameters and found that the contact rate of both strains had the largest influence on the basic reproduction numbers $${\text{R}}_{{0{\text{s}}}}$$ R 0 s and $${\text{R}}_{{0{\text{m}}}}$$ R 0 m of DS and MDR-TB, respectively. Increasingly powerful intervention strategies were developed, with realistic impact and coverage determined with the help of local staff. We simulated for the period from 2020 to 2035. Here, we projected the DS and MDR-TB burden (as measured by the number of incident cases and mortality) under a range of intervention scenarios to determine which of these scenario is the most effective at reducing burden. Of the single-intervention strategies, enhanced case detection is the most effective and prompt in reducing DS and MDR-TB incidence and mortality in Bangladesh and that with GeneXpert testing was also highly effective in decreasing the burden of MDR-TB. Our findings also suggest combining additional interventions simultaneously leads to greater effectiveness, particularly for MDR-TB, which we estimate requires a modest investment to substantially reduce, whereas DS-TB requires a strong sustained investment.Md Abdul KuddusMichael T. MeehanMd. Abu SayemEmma S. McBrydeNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-17 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Md Abdul Kuddus Michael T. Meehan Md. Abu Sayem Emma S. McBryde Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
description	Abstract Tuberculosis (TB) is a major public health problem in Bangladesh. Although the National TB control program of Bangladesh is implementing a comprehensive expansion of TB control strategies, logistical challenges exist, and there is significant uncertainty concerning the disease burden. Mathematical modelling of TB is considered one of the most effective ways to understand the dynamics of infection transmission and allows quantification of parameters in different settings, including Bangladesh. In this study, we present a two-strain mathematical modelling framework to explore the dynamics of drug-susceptible (DS) and multidrug-resistant (MDR) TB in Bangladesh. We calibrated the model using DS and MDR-TB annual incidence data from Bangladesh from years 2001 to 2015. Further, we performed a sensitivity analysis of the model parameters and found that the contact rate of both strains had the largest influence on the basic reproduction numbers $${\text{R}}_{{0{\text{s}}}}$$ R 0 s and $${\text{R}}_{{0{\text{m}}}}$$ R 0 m of DS and MDR-TB, respectively. Increasingly powerful intervention strategies were developed, with realistic impact and coverage determined with the help of local staff. We simulated for the period from 2020 to 2035. Here, we projected the DS and MDR-TB burden (as measured by the number of incident cases and mortality) under a range of intervention scenarios to determine which of these scenario is the most effective at reducing burden. Of the single-intervention strategies, enhanced case detection is the most effective and prompt in reducing DS and MDR-TB incidence and mortality in Bangladesh and that with GeneXpert testing was also highly effective in decreasing the burden of MDR-TB. Our findings also suggest combining additional interventions simultaneously leads to greater effectiveness, particularly for MDR-TB, which we estimate requires a modest investment to substantially reduce, whereas DS-TB requires a strong sustained investment.
format	article
author	Md Abdul Kuddus Michael T. Meehan Md. Abu Sayem Emma S. McBryde
author_facet	Md Abdul Kuddus Michael T. Meehan Md. Abu Sayem Emma S. McBryde
author_sort	Md Abdul Kuddus
title	Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
title_short	Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
title_full	Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
title_fullStr	Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
title_full_unstemmed	Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study
title_sort	scenario analysis for programmatic tuberculosis control in bangladesh: a mathematical modelling study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b1c5e71b0eae42bab6cef66680e5b01e
work_keys_str_mv	AT mdabdulkuddus scenarioanalysisforprogrammatictuberculosiscontrolinbangladeshamathematicalmodellingstudy AT michaeltmeehan scenarioanalysisforprogrammatictuberculosiscontrolinbangladeshamathematicalmodellingstudy AT mdabusayem scenarioanalysisforprogrammatictuberculosiscontrolinbangladeshamathematicalmodellingstudy AT emmasmcbryde scenarioanalysisforprogrammatictuberculosiscontrolinbangladeshamathematicalmodellingstudy
_version_	1718384192652312576

Scenario analysis for programmatic tuberculosis control in Bangladesh: a mathematical modelling study

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