Mass treatment to eliminate tuberculosis from an island population

Int J Tuberc Lung Dis. 2014 Aug;18(8):899-904. doi: 10.5588/ijtld.14.0007.


Setting: The global target of tuberculosis (TB) elimination by 2050 requires new approaches. Active case finding plus mass prophylactic treatment has been disappointing. We consider mass full anti-tuberculosis treatment as an approach to TB elimination in Kiribati, a Pacific Island nation, with a persistent epidemic of high TB incidence.

Objective: To construct a mathematical model to predict whether mass treatment with a full course of anti-tuberculosis drugs might eliminate TB from the defined population of the Republic of Kiribati.

Methods: We constructed a seven-state compartmental model of the life cycle of Mycobacterium tuberculosis in which active TB disease arises from the progression of infection, reinfection, reactivation and relapse, while distinguishing infectious from non-infectious disease. We evaluated the effects of 5-yearly mass treatment using a range of parameter values to generate outcomes in uncertainty analysis.

Results: Assuming population-wide treatment effectiveness for latent tuberculous infection and active TB of ⩾90%, annual TB incidence is expected to fall sharply at each 5-yearly round of treatment, approaching elimination in two decades. The model showed that the incidence rate is sensitive to the relapse rate after successful treatment of TB.

Conclusion: Mass treatment may help to eliminate TB, at least for discrete or geographically isolated populations.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Humans
  • Incidence
  • Infant
  • Latent Tuberculosis / drug therapy
  • Latent Tuberculosis / epidemiology
  • Latent Tuberculosis / microbiology
  • Male
  • Micronesia / epidemiology
  • Middle Aged
  • Models, Theoretical*
  • Mycobacterium tuberculosis / pathogenicity*
  • Recurrence
  • Time Factors
  • Tuberculosis / epidemiology
  • Tuberculosis / microbiology
  • Tuberculosis / prevention & control*
  • Young Adult


  • Antitubercular Agents