Understanding, predicting and controlling the emergence of drug-resistant tuberculosis : a theoretical framework

• Published in: Journal of molecular medicine (Berlin, Germany) Vol. 76; no. 9; pp. 624 - 636
• Main Authors: BLOWER, S. M, GERBERDING, J. L
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-08-1998
• Subjects: Bacterial diseases; Biological and medical sciences; Disease Outbreaks; Drug Resistance, Microbial; Health Policy; Human bacterial diseases; Humans; Infectious diseases; Medical sciences; Models, Biological; Mycobacterium tuberculosis; Tuberculosis - epidemiology; Tuberculosis - microbiology; Tuberculosis - prevention & control; Tuberculosis and atypical mycobacterial infections; Infection; Human; Antibiotic; Microorganism resistance; Tuberculosis; Emergence; Bacteriosis; Mycobacterial infection; Antibacterial agent; Mathematical model; Epidemiology; Statistical study
• ISSN: 0946-2716; 1432-1440
• DOI: 10.1007/s001090050260

The high prevalence of tuberculosis in developing countries and the recent resurgence of tuberculosis in many developed countries suggests that current control strategies are suboptimal. The increase in drug-resistant cases exacerbates the control problems. Currently employed epidemic control strategies are not devised on the basis of a theoretical understanding of the transmission dynamics of Mycobacterium tuberculosis. We describe and discuss a theoretical framework based upon mathematical transmission models that can be used for understanding, predicting, and controlling tuberculosis epidemics. We illustrate how the theoretical framework can be used to predict the temporal dynamics of the emergence of drug resistance, to predict the epidemiological consequences of epidemic control strategies in developing and developed countries, and to design epidemic control strategies.