Application of a dynamic model on the prediction of pulmonary tuberculosis incidence and control strategy evaluation in Tianjin, China

doi:10.3969/j.issn.1000-6621.2021.10.012

Abstract

Abstract:

Objective A dynamic model was established to predict the pulmonary tuberculosis (PTB) reporting incidence rate in Tianjin, and to provide scientific evidences for optimizing PTB control strategies. Methods Based on PTB transmission mechanism, a dynamic transmission model of TB was established and the basic regeneration number ?₀was calculated. Fitting the model with the PTB reporting incidence rates in Tianjin from 2008 to 2015, the trends of PTB reporting incidence rate in Tianjin were predicted, and the relative errors between the predicted value and the validation data of PTB reporting incidence rates from 2016 to 2018 were calculated. The effects of different TB prevention and control strategies were evaluated by adjusting the value of parameters: reducing the infection rate of susceptible people (β₁, β₂); reducing the progressing rate of latent infection to active tuberculosis patients (κ₁, κ₂); reducing the recurrence rate of patients with successful treatment (ω₁, ω₂). Results The basic regeneration number ?₀of PTB transmission in Tianjing was 0.259 <1, the disease-free equilibriums was global asymptotically stable. The relative errors between predicted values and validation data of reporting incidence rates were 0.76%, 1.30% and -1.54% in 2016, 2017 and 2018, respectively, which were relatively accurate. The PTB reporting incidence rate in Tianjin will decline to 18.3 per 100000 in 2035. Keeping other parameter values unchanged, the PTB reporting incidence rate in Tianjin will be 17.8 per 100000 in 2035 if β₁ and β₂ declined by 50%; the PTB reporting incidence rate will be 9.86 per 100000 in 2035 if κ₁ and κ₂ declined by 50%; and the PTB reporting incidence rate will be 17.9 per 100000 in 2035 if ω₁ and ω₂ declined by 50%. Conclusion The WHO End TB Strategies target in 2035 (incidence rate <10 per 100000) is hard to be achieved in Tianjin under current prevention and control strategies. It is suggested to enhance effective management of latent TB infection population.

Key words: Tuberculosis, pulmonary, Kinetics, Models, theoretical, Forecasting, Tianjin City

YU She-gen, JIA Zhong-wei. Application of a dynamic model on the prediction of pulmonary tuberculosis incidence and control strategy evaluation in Tianjin, China[J]. Chinese Journal of Antituberculosis, 2021, 43(10): 1039-1045. doi: 10.3969/j.issn.1000-6621.2021.10.012

Figures/Tables 6

References 29

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参数	定义	参数取值	参考文献
Λ	人口的自然补充率	1.02×10⁵	[10]
β₁	非耐多药肺结核患者与易感者接触的传染率	1.47×10^-13	与疫情拟合
β₂	耐多药肺结核患者与易感者接触的传染率	2.15×10^-11	与疫情拟合
κ	结核分枝杆菌潜伏感染向初治肺结核患者的进展率	1.22×10^-3	与疫情拟合
σ₁	初治肺结核患者耐多药率	6.60×10^-2	[12]
ρ	非耐多药肺结核患者向耐多药肺结核患者的进展率	6.81×10^-2	[13]
τ	活动性肺结核患者发现率	6.48×10^-1	[1]
γ₁	非耐多药肺结核患者的治疗成功率	9.30×10^-1	[14]
γ₂	耐多药肺结核患者的治疗成功率	7.10×10^-1	[15]
μ₀	人口的自然死亡率	4.63×10^-3	[10]
μ₁	非耐多药肺结核患者的因病死亡率	3.71×10^-3	[14]
μ₂	耐多药肺结核患者的因病死亡率	1.26×10^-2	[15]
ω	治疗成功者的复发率	6.80×10^-2	[16]
σ₂	复发患者的耐多药率	1.31×10^-1	[17]