Impact of tuberculosis treatment length and adherence under different transmission intensities

Tuberculosis (TB) is a leading cause of human mortality due to infectious disease. Treatment default is a relevant factor which reduces therapeutic success and increases the risk of resistant TB. In this work we analyze the relation between treatment default and treatment length along with its conse...

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Bibliographic Details
Published in:Theoretical population biology 2015-09, Vol.104, p.68-77
Main Authors: Pinho, S.T.R., Rodrigues, P., Andrade, R.F.S., Serra, H., Lopes, J.S., Gomes, M.G.M.
Format: Article
Language:English
Subjects:
Antitubercular Agents - administration & dosage
Default
Drug Administration Schedule
Humans
Mathematical model
Medication Adherence
Models, Biological
Mycobacterium
Reinfection
Treatment
Tuberculosis
Tuberculosis - drug therapy
Tuberculosis - transmission
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Summary:Tuberculosis (TB) is a leading cause of human mortality due to infectious disease. Treatment default is a relevant factor which reduces therapeutic success and increases the risk of resistant TB. In this work we analyze the relation between treatment default and treatment length along with its consequence on the disease spreading. We use a stylized model structure to explore, systematically, the effects of varying treatment duration and compliance. We find that shortening treatment alone may not reduce TB prevalence, especially in regions where transmission intensity is high, indicating the necessity of complementing this action with increased compliance. A family of default functions relating the proportion of defaulters to the treatment length is considered and adjusted to a particular dataset. We find that the epidemiological benefits of shorter treatment regimens are tightly associated with increases in treatment compliance and depend on the epidemiological background.
ISSN:0040-5809
1096-0325
DOI:10.1016/j.tpb.2015.06.004