Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities
Abstract Background In Canada, active tuberculosis (TB) disease rates remain disproportionately higher among the Indigenous population, especially among the Inuit in the north. We used mathematical modeling to evaluate how interventions might enhance existing TB control efforts in a region of Nunavu...
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ftdoajarticles:oai:doaj.org/article:03269b55250944aa9f993819cbae18b1 2023-05-15T16:55:16+02:00 Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities Ashleigh R. Tuite Victor Gallant Elaine Randell Annie-Claude Bourgeois Amy L. Greer 2017-01-01T00:00:00Z https://doi.org/10.1186/s12889-016-3996-7 https://doaj.org/article/03269b55250944aa9f993819cbae18b1 EN eng BMC http://link.springer.com/article/10.1186/s12889-016-3996-7 https://doaj.org/toc/1471-2458 doi:10.1186/s12889-016-3996-7 1471-2458 https://doaj.org/article/03269b55250944aa9f993819cbae18b1 BMC Public Health, Vol 17, Iss 1, Pp 1-12 (2017) Canada Latent TB infection Mathematical model Nunavut Public health Simulation Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1186/s12889-016-3996-7 2022-12-31T12:00:28Z Abstract Background In Canada, active tuberculosis (TB) disease rates remain disproportionately higher among the Indigenous population, especially among the Inuit in the north. We used mathematical modeling to evaluate how interventions might enhance existing TB control efforts in a region of Nunavut. Methods We developed a stochastic, agent-based model of TB transmission that captured the unique household and community structure. Evaluated interventions included: (i) rapid treatment of active cases; (ii) rapid contact tracing; (iii) expanded screening programs for latent TB infection (LTBI); and (iv) reduced household density. The outcomes of interest were incident TB infections and total diagnosed active TB disease over a 10- year time period. Results Model-projected incidence in the absence of additional interventions was highly variable (range: 33–369 cases) over 10 years. Compared to the ‘no additional intervention’ scenario, reducing the time between onset of active TB disease and initiation of treatment reduced both the number of new TB infections (47% reduction, relative risk of TB = 0.53) and diagnoses of active TB disease (19% reduction, relative risk of TB = 0.81). Expanding general population screening was also projected to reduce the burden of TB, although these findings were sensitive to assumptions around the relative amount of transmission occurring outside of households. Other potential interventions examined in the model (school-based screening, rapid contact tracing, and reduced household density) were found to have limited effectiveness. Conclusions In a region of northern Canada experiencing a significant TB burden, more rapid treatment initiation in active TB cases was the most impactful intervention evaluated. Mathematical modeling can provide guidance for allocation of limited resources in a way that minimizes disease transmission and protects population health. Article in Journal/Newspaper inuit Nunavut Directory of Open Access Journals: DOAJ Articles Canada Nunavut BMC Public Health 17 1 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Canada Latent TB infection Mathematical model Nunavut Public health Simulation Public aspects of medicine RA1-1270 |
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Canada Latent TB infection Mathematical model Nunavut Public health Simulation Public aspects of medicine RA1-1270 Ashleigh R. Tuite Victor Gallant Elaine Randell Annie-Claude Bourgeois Amy L. Greer Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
topic_facet |
Canada Latent TB infection Mathematical model Nunavut Public health Simulation Public aspects of medicine RA1-1270 |
description |
Abstract Background In Canada, active tuberculosis (TB) disease rates remain disproportionately higher among the Indigenous population, especially among the Inuit in the north. We used mathematical modeling to evaluate how interventions might enhance existing TB control efforts in a region of Nunavut. Methods We developed a stochastic, agent-based model of TB transmission that captured the unique household and community structure. Evaluated interventions included: (i) rapid treatment of active cases; (ii) rapid contact tracing; (iii) expanded screening programs for latent TB infection (LTBI); and (iv) reduced household density. The outcomes of interest were incident TB infections and total diagnosed active TB disease over a 10- year time period. Results Model-projected incidence in the absence of additional interventions was highly variable (range: 33–369 cases) over 10 years. Compared to the ‘no additional intervention’ scenario, reducing the time between onset of active TB disease and initiation of treatment reduced both the number of new TB infections (47% reduction, relative risk of TB = 0.53) and diagnoses of active TB disease (19% reduction, relative risk of TB = 0.81). Expanding general population screening was also projected to reduce the burden of TB, although these findings were sensitive to assumptions around the relative amount of transmission occurring outside of households. Other potential interventions examined in the model (school-based screening, rapid contact tracing, and reduced household density) were found to have limited effectiveness. Conclusions In a region of northern Canada experiencing a significant TB burden, more rapid treatment initiation in active TB cases was the most impactful intervention evaluated. Mathematical modeling can provide guidance for allocation of limited resources in a way that minimizes disease transmission and protects population health. |
format |
Article in Journal/Newspaper |
author |
Ashleigh R. Tuite Victor Gallant Elaine Randell Annie-Claude Bourgeois Amy L. Greer |
author_facet |
Ashleigh R. Tuite Victor Gallant Elaine Randell Annie-Claude Bourgeois Amy L. Greer |
author_sort |
Ashleigh R. Tuite |
title |
Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
title_short |
Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
title_full |
Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
title_fullStr |
Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
title_full_unstemmed |
Stochastic agent-based modeling of tuberculosis in Canadian Indigenous communities |
title_sort |
stochastic agent-based modeling of tuberculosis in canadian indigenous communities |
publisher |
BMC |
publishDate |
2017 |
url |
https://doi.org/10.1186/s12889-016-3996-7 https://doaj.org/article/03269b55250944aa9f993819cbae18b1 |
geographic |
Canada Nunavut |
geographic_facet |
Canada Nunavut |
genre |
inuit Nunavut |
genre_facet |
inuit Nunavut |
op_source |
BMC Public Health, Vol 17, Iss 1, Pp 1-12 (2017) |
op_relation |
http://link.springer.com/article/10.1186/s12889-016-3996-7 https://doaj.org/toc/1471-2458 doi:10.1186/s12889-016-3996-7 1471-2458 https://doaj.org/article/03269b55250944aa9f993819cbae18b1 |
op_doi |
https://doi.org/10.1186/s12889-016-3996-7 |
container_title |
BMC Public Health |
container_volume |
17 |
container_issue |
1 |
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1766046242463285248 |