title: On treatment of tuberculosis in heterogeneous populations.
abstract: Global eradication of tuberculosis (TB) is an international agenda. Thus understanding effects of treatment of TB in different settings is crucial. In previous work, we introduced the framework for a mathematical model of epidemic TB in demographically distinct, heterogeneous populations. Simulations showed the importance of genetic susceptibility in determining endemic prevalence levels. In the work presented here, we include treatment and investigate different strategies for treatment of latent and active TB disease in heterogeneous populations. We illustrate how the presence of a genetically susceptible subpopulation dramatically alters effects of treatment in the same way a core population does in the setting of sexually transmitted diseases. In addition, we evaluate treatment strategies that focus specifically on this subpopulation, and our results indicate that genetically susceptible subpopulations should be accounted for when designing treatment strategies to achieve the greatest reduction in disease prevalence.
authors.affiliation: Department of Microbiology and Immunology, The University of Michigan Medical School, University of Michigan at Ann Arbor, 6730 Medical Science II, MC 0620, Ann Arbor, MI 48109-0620, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Murphy
authors.forename: Benjamin H
authors.initials: BH
authors.lastname: Singer
authors.forename: Denise
authors.initials: D
authors.lastname: Kirschner
mesh_terms: D003710:Demography; D004196:Disease Outbreaks; D018450:Disease Progression; D020022:Genetic Predisposition to Disease; D014943:Global Health; D006801:Humans; D015233:Models, Statistical; D009169:Mycobacterium tuberculosis; D055502:Secondary Prevention; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000235:genetics