| The transmission and control of XDR TB in South Africa: an operations research and mathematical modelling approach. | |
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MedLine Citation:
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PMID: 18606028 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Extensively drug-resistant tuberculosis (XDR TB) has emerged as a threat to TB control efforts in several high-burden areas, generating international concern. XDR TB is now found in every region of the world, but appears most worrisome in the context of HIV and in resource-limited settings with congregate hospital wards. Here, we examine the emergence and transmission dynamics of the disease, incorporating the mathematical modelling literature related to airborne infection and epidemiological studies related to the operations of TB control programmes in resource-limited settings. We find that while XDR TB may present many challenges in the setting of resource constraints, the central problems highlighted by the emergence of XDR TB are those that have plagued TB programmes for years. These include a slow rate of case detection that permits prolonged infectiousness, the threat of airborne infection in enclosed spaces, the problem of inadequate treatment delivery and treatment completion, and the need to develop health systems that can address the combination of TB and poverty. Mathematical models of TB transmission shed light on the idea that community-based therapy and rapid detection systems may be beneficial in resource-limited settings, while congregate hospital wards are sites for major structural reform. |
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Authors:
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S Basu; A P Galvani |
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Publication Detail:
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Type: Journal Article; Review Date: 2008-07-07 |
Journal Detail:
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Title: Epidemiology and infection Volume: 136 ISSN: 0950-2688 ISO Abbreviation: Epidemiol. Infect. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-12 Completed Date: 2008-12-16 Revised Date: 2010-09-21 |
Medline Journal Info:
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Nlm Unique ID: 8703737 Medline TA: Epidemiol Infect Country: England |
Other Details:
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Languages: eng Pagination: 1585-98 Citation Subset: IM |
Affiliation:
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Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510, USA. sanjay.basu@yale.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Extensively Drug-Resistant Tuberculosis
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epidemiology,
prevention & control*,
transmission* Humans Models, Theoretical* Rural Health South Africa / epidemiology |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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