Journal article

The Importance of Heterogeneity to the Epidemiology of Tuberculosis

James M Trauer, Peter J Dodd, M Gabriela M Gomes, Gabriela B Gomez, Rein MGJ Houben, Emma S McBryde, Yayehirad A Melsew, Nicolas A Menzies, Nimalan Arinaminpathy, Sourya Shrestha, David W Dowdy

Clinical Infectious Diseases | OXFORD UNIV PRESS INC | Published : 2019

Abstract

Although less well-recognized than for other infectious diseases, heterogeneity is a defining feature of tuberculosis (TB) epidemiology. To advance toward TB elimination, this heterogeneity must be better understood and addressed. Drivers of heterogeneity in TB epidemiology act at the level of the infectious host, organism, susceptible host, environment, and distal determinants. These effects may be amplified by social mixing patterns, while the variable latent period between infection and disease may mask heterogeneity in transmission. Reliance on notified cases may lead to misidentification of the most affected groups, as case detection is often poorest where prevalence is highest. Assumin..

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Grants

Awarded by National Health and Medical Research Council, Australia


Awarded by European Research Council under the European Union's Horizon 2020 research and innovation programme


Awarded by Medical Research Council, United Kingdom


Funding Acknowledgements

This perspective piece arose out of discussions of the Modelling Research Group at the annual meeting of the TB Modelling and Analysis Consortium, which is funded by the Bill & Melinda Gates Foundation. J. M. T. is a recipient of an Early Career Fellowship from the National Health and Medical Research Council, Australia (fellowship number APP1142638). R. M. G. J. H. received funding from the European Research Council under the European Union's Horizon 2020 research and innovation programme (grant agreement number 757699). P. J. D. is supported by the Medical Research Council, United Kingdom (fellowship number MR/P022081/1).