Assortative social mixing and sex disparities in tuberculosis burden.
Assortative social mixing and sex disparities in tuberculosis burden.
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DOI：
10.1038/s41598-021-86869-w
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发表时间：
2021-04-06
影响因子：
4.6
通讯作者：
Dodd PJ
中科院分区：
文献类型：
--
作者：
Shaweno D;Horton KC;Hayes RJ;Dodd PJ
在全球范围内，男性的结核病(TB)负担更高，但这种性别差异背后的机制尚未完全了解。最近对社会融合模式的调查表明，在许多环境中，性别内的融合是适度优先的。这种分类混合可能会放大与其他原因的差异。我们使用一个性别分层的确定性结核病传播模型，探索了分类混合和不同因素对疾病进展和检测的影响。我们探讨了在无病平衡和地方病平衡中的配合性的影响，发现在发病期间和在增加男性：女性患病率(M：F)方面的影响比总体患病率更大。基于方差的地方病平衡敏感性分析表明，差异级数是M：F比率不确定性的最重要驱动因素。我们将我们的模型适用于完全贝叶斯框架内样本设置中的流行率和通报数据。对于我们的高M：F设置，随机混合会使平衡M：F比降低12%(95%CRI 0-30%)。在那里，使男性病例发现率持平，导致男性：女性比例在10年内下降了20%(95%CRI11-31%)--不足以消除性别差异。然而，这一潜在可实现的改善与在这一时间框架内总结核病患病率有意义地降低了8%(95%CRI4-14%)有关。
Globally, men have higher tuberculosis (TB) burden but the mechanisms underlying this sex disparity are not fully understood. Recent surveys of social mixing patterns have established moderate preferential within-sex mixing in many settings. This assortative mixing could amplify differences from other causes. We explored the impact of assortative mixing and factors differentially affecting disease progression and detection using a sex-stratified deterministic TB transmission model. We explored the influence of assortativity at disease-free and endemic equilibria, finding stronger effects during invasion and on increasing male:female prevalence (M:F) ratios than overall prevalence. Variance-based sensitivity analysis of endemic equilibria identified differential progression as the most important driver of M:F ratio uncertainty. We fitted our model to prevalence and notification data in exemplar settings within a fully Bayesian framework. For our high M:F setting, random mixing reduced equilibrium M:F ratios by 12% (95% CrI 0–30%). Equalizing male case detection there led to a 20% (95% CrI 11–31%) reduction in M:F ratio over 10 years—insufficient to eliminate sex disparities. However, this potentially achievable improvement was associated with a meaningful 8% (95% CrI 4–14%) reduction in total TB prevalence over this time frame.
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影响因子：
3.7
作者：
Glynn, Judith R.;Guerra-Assuncao, Jose Afonso;Clark, Taane G.
通讯作者：
Clark, Taane G.
影响因子：
5
作者：
Dodd PJ;Looker C;Plumb ID;Bond V;Schaap A;Shanaube K;Muyoyeta M;Vynnycky E;Godfrey-Faussett P;Corbett EL;Beyers N;Ayles H;White RG
通讯作者：
White RG
DOI：
10.1093/infdis/jix354
发表时间：
2017-11-03
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Mathema B;Andrews JR;Cohen T;Borgdorff MW;Behr M;Glynn JR;Rustomjee R;Silk BJ;Wood R
通讯作者：
Wood R
影响因子：
12.7
作者：
Hargreaves JR;Boccia D;Evans CA;Adato M;Petticrew M;Porter JD
通讯作者：
Porter JD
影响因子：
9.3
作者：
MacPherson, Peter;Khundi, McEwen;Corbett, Elizabeth L.
通讯作者：
Corbett, Elizabeth L.