Mathematical models of the epidemiology and control of drug-resistant TB.
Mathematical models of the epidemiology and control of drug-resistant TB.
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DOI：
10.1586/17476348.3.1.67
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发表时间：
2009-02-01
影响因子：
3.9
通讯作者：
Murray, Megan
中科院分区：
文献类型：
--
作者：
Cohen, Ted;Dye, Christopher;Murray, Megan
最近关于南非广泛耐药结核病的报道再次引发了人们的担忧，即抗生素耐药性可能会破坏结核病控制的进展。我们回顾了数学模型阐明耐药结核病流行病学和控制的三个主要问题。如何在接受联合化疗的个体中选择多重耐药结核分枝杆菌？哪些因素决定了耐药结核病的流行？哪些预防耐药结核病传播的干预措施是有效且可行的？模型可以深入了解耐药性的获得和放大，揭示区分耐药结核分枝杆菌繁殖能力的内在和外在决定因素的重要性，并证明耐药结核病干预措施的成本效益。这些模型还突出了知识差距，新的研究将提高我们预测耐药性趋势并制定更有效的控制政策的能力。
Recent reports of extensively drug-resistant TB in South Africa have renewed concerns that antibiotic resistance may undermine progress in TB control. We review three major questions for which mathematical models elucidate the epidemiology and control of drug-resistant TB. How is multiple drug-resistant Mycobacterium tuberculosis selected for in individuals exposed to combination chemotherapy? What factors determine the prevalence of drug-resistant TB? Which interventions to prevent the spread of drug-resistant TB are effective and feasible? Models offer insight into the acquisition and amplification of drug resistance, reveal the importance of distinguishing the intrinsic and extrinsic determinants of the reproductive capacity of drug-resistant M. tuberculosis, and demonstrate the cost effectiveness of interventions for drug-resistant TB. These models also highlight knowledge gaps for which new research will improve our ability to project trends of drug resistance and develop more effective policies for its control.