PMID: 8968016Dec 18, 1996Paper

Evaluation of tuberculosis control policies using computer simulation

JAMA : the Journal of the American Medical Association
T F BrewerH V Fineberg

Abstract

To develop more effective methods to assess tuberculosis (TB) control strategies so we can meet national goals for the elimination of TB in the United States. Using a semi-Markov model that divided the US population into 3 age groups and 18 clinical states based on disease status and risk for TB and human immunodeficiency virus (HIV) infection, we measured the effects of 5 changes in TB policy, introduced singly and in combination: (1) increased coverage and (2) improved efficacy of preventive therapy, (3) increased coverage and (4) improved efficacy of treatment, and (5) introduction of BCG vaccination. A BCG vaccination program that reached 10% of eligible children and 1% of eligible adults each year would produce a 17% reduction in cases and an 11% decline in deaths over 10 years. Preventive therapy programs among the general population would have little effect on the number of TB cases, but a program targeting HIV-infected patients would reduce HIV-associated TB cases and deaths 14% to 20%. A 10% improvement in the coverage and efficacy of both preventive therapy and treatment, coupled with the BCG vaccination program, would lead to a 47% decline in TB cases and a 50% decline in TB deaths relative to baseline over 10 years....Continue Reading

Citations

Oct 12, 2005·Archives of Medical Research·Timothy F Brewer, S Jody Heymann
Dec 18, 2001·Journal of Acquired Immune Deficiency Syndromes : JAIDS·T C PorcoS M Blower
Mar 6, 2012·Mathematical Biosciences·Cagri OzcaglarKristin P Bennett

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