Are survey-based estimates of the burden of drug resistant TB too low? Insight from a simulation study.
Are survey-based estimates of the burden of drug resistant TB too low? Insight from a simulation study.
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DOI：
10.1371/journal.pone.0002363
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发表时间：
2008-06-04
期刊：
影响因子：
3.7
通讯作者：
Murray M
中科院分区：
文献类型：
--
作者：
Cohen T;Colijn C;Finklea B;Wright A;Zignol M;Pym A;Murray M
对多种一线和二线抗生素产生耐药性的结核病的出现对依赖标准药物治疗方案的全球控制战略提出了挑战。结核分枝杆菌的高度耐药菌株与疫情有关，并已在世界各地发现;全面了解这一威胁的严重性需要准确评估全球耐药负担。不幸的是，在许多出现耐药性的情况下，实验室能力有限，对耐药性负担的估计是通过对发病病例样本进行药物敏感性测试而不是通过使用常规监测来获得的。使用基于个体的动态结核病模型模拟耐药性监测策略，我们发现，目前的调查可能低估了耐药结核病的总负担，因为获得性耐药病例被低估，流行病例中的耐药性没有评估。我们探讨了这种偏见是如何受到流行病的成熟和针对耐药结核病的出现和传播的干预措施的影响。基于发病病例样本的耐药结核病估计值应被视为耐药总负担的下限。
The emergence of tuberculosis resistant to multiple first- and second-line antibiotics poses challenges to a global control strategy that relies on standard drug treatment regimens. Highly drug-resistant strains of Mycobacterium tuberculosis have been implicated in outbreaks and have been found throughout the world; a comprehensive understanding the magnitude of this threat requires an accurate assessment of the worldwide burden of resistance. Unfortunately, in many settings where resistance is emerging, laboratory capacity is limited and estimates of the burden of resistance are obtained by performing drug sensitivity testing on a sample of incident cases rather than through the use of routine surveillance. Using an individual-based dynamic tuberculosis model to simulate surveillance strategies for drug resistance, we found that current surveys may underestimate the total burden of resistant tuberculosis because cases of acquired resistance are undercounted and resistance among prevalent cases is not assessed. We explored how this bias is affected by the maturity of the epidemic and by the introduction of interventions that target the emergence and spread of resistant tuberculosis. Estimates of drug resistant tuberculosis based on samples of incident cases should be viewed as a lower bound of the total burden of resistance.
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DOI：
10.1073/pnas.140102797
发表时间：
2000-07-05
影响因子：
11.1
作者：
Dye, C;Williams, BG
通讯作者：
Williams, BG
DOI：
10.1164/rccm.200503-449oc
发表时间：
2005-09-01
影响因子：
24.7
作者：
van Rie, A;Victor, TC;Warren, RM
通讯作者：
Warren, RM
DOI：
10.1098/rspb.1997.0178
发表时间：
1997-09-22
影响因子：
4.7
作者：
Schrag, SJ;Perrot, V;Levin, BR
通讯作者：
Levin, BR
影响因子：
9.4
作者：
Richardson, M;Carroll, NM;van Helden, PD
通讯作者：
van Helden, PD
影响因子：
56.9
作者：
Björkman, J;Nagaev, I;Andersson, DI
通讯作者：
Andersson, DI