Pai, Madhukar, Brooks-Pollock, Ellen, Cohen, Ted and Murray, Megan (2010) The impact of realistic age structure in simple models of tuberculosis transmission. PLoS One, Vol.5 (No.1). Article no. e8479. doi:10.1371/journal.pone.0008479 ISSN 1932-6203.
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Abstract
Background : Mathematical models of tuberculosis (TB) transmission have been used to characterize disease dynamics, investigate the potential effects of public health interventions, and prioritize control measures. While previous work has addressed the mathematical description of TB natural history, the impact of demography on the behaviour of TB models has not been assessed.
Methods : A simple model of TB transmission, with alternative assumptions about survivorship, is used to explore the effect of age structure on the prevalence of infection, disease, basic reproductive ratio and the projected impact of control interventions. We focus our analytic arguments on the differences between constant and exponentially distributed lifespans and use an individual-based model to investigate the range of behaviour arising from realistic distributions of survivorship.
Results : The choice of age structure and natural (non-disease related) mortality strongly affects steady-state dynamics, parameter estimation and predictions about the effectiveness of control interventions. Since most individuals infected with TB develop an asymptomatic latent infection and never progress to active disease, we find that assuming a constant mortality rate results in a larger reproductive ratio and an overestimation of the effort required for disease control in comparison to using more realistic age-specific mortality rates.
Conclusions : Demographic modelling assumptions should be considered in the interpretation of models of chronic infectious diseases such as TB. For simple models, we find that assuming constant lifetimes, rather than exponential lifetimes, produces dynamics more representative of models with realistic age structure.
| Item Type: | Journal Article |
|---|---|
| Subjects: | Q Science > QA Mathematics |
| Divisions: | Faculty of Science, Engineering and Medicine > Science > Mathematics |
| Journal or Publication Title: | PLoS One |
| Publisher: | Public Library of Science |
| ISSN: | 1932-6203 |
| Official Date: | 2010 |
| Dates: | Date Event 2010 Published |
| Volume: | Vol.5 |
| Number: | No.1 |
| Number of Pages: | 6 |
| Page Range: | Article no. e8479 |
| DOI: | 10.1371/journal.pone.0008479 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Open Access (Creative Commons open licence) |
| Funder: | National Institutes of Health (NIH) |
| Grant number: | U19 AI076217 |
| URI: | https://wrap.warwick.ac.uk/48376/ |
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