Effect of different interventions for latent tuberculosis infections in China: a model-based study

BMC Infect Dis. 2022 May 23;22(1):488. doi: 10.1186/s12879-022-07465-5.

Abstract

Background: Tuberculosis (TB) has a serious impact on people's health. China is one of 30 countries that has a high TB burden. As the currently decreasing speed of the incidence of TB, the WHO's goal of "End TB Strategy" is hard to achieve by 2035. As a result, a SEIR model that determines the impact of different tuberculosis preventive treatments (TPTs) in different age groups, and the effect of different interventions on latent TB infections (LTBIs) in China is developed.

Methods: A Susceptible-Exposed-Infectious-Recovered (SEIR) model was established. Goodness-of-fit tests were used to assess model performance. Predictive analysis was used to assess the effect of different interventions on LTBIs and achieving the goals of the "End TB Strategy".

Results: The Chi-square test indicated the model provided a good statistical fit to previous data on the incidence of TB (χ2 = 0.3085, p > 0.999). The 1HP treatment regimen (daily rifapentine + isoniazid for 4 weeks) was most effective in reducing the number of TB cases by 2035. The model indicated that several strategies could achieve the 2035 target of the "End TB Strategy": completion of active case finding (ACF) for LTBI and TPT nation-wide within 5 years; completion of ACF for LTBIs and TPT within 2 years in high-incidence areas; completion of TPT in the elderly within 2 years; or introduction of a new vaccine in which the product of annual doses and vaccine efficiency in the three age groups above 14 years old reached 10.5 million.

Conclusion: The incidence of TB in China declined gradually from 2005 to 2019. Implementation of ACF for LTBIs and TPT nation-wide or in areas with high incidence, in the elderly, or administration of a new and effective vaccine could greatly reduce the number of TB cases and achieve the 2035 target of the "End TB Strategy" in China.

Keywords: Active case finding; Intervention strategy; Preventive treatment; SEIR model; Screen; Tuberculosis.

MeSH terms

  • Adolescent
  • Aged
  • Antitubercular Agents / therapeutic use
  • China / epidemiology
  • Humans
  • Incidence
  • Isoniazid / therapeutic use
  • Latent Tuberculosis* / drug therapy
  • Latent Tuberculosis* / epidemiology
  • Latent Tuberculosis* / prevention & control
  • Tuberculosis* / drug therapy
  • Tuberculosis* / epidemiology
  • Tuberculosis* / prevention & control

Substances

  • Antitubercular Agents
  • Isoniazid