Transmission modeling to infer tuberculosis incidence prevalence and mortality in settings with generalized HIV epidemics

Dodd, P. J., Shaweno, D., Ku, C.-C., Glaziou, P., Pretorius, C., Hayes, R. J., MacPherson, P. , Cohen, T. and Ayles, H. (2023) Transmission modeling to infer tuberculosis incidence prevalence and mortality in settings with generalized HIV epidemics. Nature Communications, 14, 1639. (doi: 10.1038/s41467-023-37314-1) (PMID:36964130) (PMCID:PMC10037365)

Abstract

Tuberculosis (TB) killed more people globally than any other single pathogen over the past decade. Where surveillance is weak, estimating TB burden estimates uses modeling. In many African countries, increases in HIV prevalence and antiretroviral therapy have driven dynamic TB epidemics, complicating estimation of burden, trends, and potential intervention impact. We therefore develop a novel age-structured TB transmission model incorporating evolving demographic, HIV and antiretroviral therapy effects, and calibrate to TB prevalence and notification data from 12 African countries. We use Bayesian methods to include uncertainty for all TB model parameters, and estimate age-specific annual risks of TB infection, finding up to 16.0%/year in adults, and the proportion of TB incidence from recent (re)infection, finding a mean across countries of 34%. Rapid reduction of the unacceptably high burden of TB in high HIV prevalence settings will require interventions addressing progression as well as transmission.

• Item Type: Articles
• Additional Information: This work was funded by an MRC fellowship to P.J.D. (MR/P022081/1) and by the TREATS study (RIA2016S-1632-TREATS); part of the EDCTP2 programme supported by the European Union. This research was funded in whole, or in part, by the Wellcome Trust [206575/Z/17/Z].
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacPherson, Professor Peter
• Authors: Dodd, P. J., Shaweno, D., Ku, C.-C., Glaziou, P., Pretorius, C., Hayes, R. J., MacPherson, P., Cohen, T., and Ayles, H.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Nature Communications
• Publisher: Nature Research
• ISSN: 2041-1723
• ISSN (Online): 2041-1723
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Nature Communications 14: 1639
• Publisher Policy: Reproduced under a Creative Commons License