Quantifying TB transmission: a systematic review of reproduction number and serial interval estimates for tuberculosis

Epidemiol Infect. 2018 Sep;146(12):1478-1494. doi: 10.1017/S0950268818001760. Epub 2018 Jul 4.


Tuberculosis (TB) is the leading global infectious cause of death. Understanding TB transmission is critical to creating policies and monitoring the disease with the end goal of TB elimination. To our knowledge, there has been no systematic review of key transmission parameters for TB. We carried out a systematic review of the published literature to identify studies estimating either of the two key TB transmission parameters: the serial interval (SI) and the reproductive number. We identified five publications that estimated the SI and 56 publications that estimated the reproductive number. The SI estimates from four studies were: 0.57, 1.42, 1.44 and 1.65 years; the fifth paper presented age-specific estimates ranging from 20 to 30 years (for infants <1 year old) to <5 years (for adults). The reproductive number estimates ranged from 0.24 in the Netherlands (during 1933-2007) to 4.3 in China in 2012. We found a limited number of publications and many high TB burden settings were not represented. Certain features of TB dynamics, such as slow transmission, complicated parameter estimation, require novel methods. Additional efforts to estimate these parameters for TB are needed so that we can monitor and evaluate interventions designed to achieve TB elimination.

Keywords: Reproductive number; serial interval; systematic review; tuberculosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Systematic Review

MeSH terms

  • Age Factors
  • China / epidemiology
  • Disease Transmission, Infectious*
  • Humans
  • Netherlands / epidemiology
  • Population Dynamics
  • Tuberculosis / epidemiology
  • Tuberculosis / transmission*