title: Impact of tuberculosis treatment length and adherence under different transmission intensities.
abstract: Tuberculosis (TB) is a leading cause of human mortality due to infectious disease. Treatment default is a relevant factor which reduces therapeutic success and increases the risk of resistant TB. In this work we analyze the relation between treatment default and treatment length along with its consequence on the disease spreading. We use a stylized model structure to explore, systematically, the effects of varying treatment duration and compliance. We find that shortening treatment alone may not reduce TB prevalence, especially in regions where transmission intensity is high, indicating the necessity of complementing this action with increased compliance. A family of default functions relating the proportion of defaulters to the treatment length is considered and adjusted to a particular dataset. We find that the epidemiological benefits of shorter treatment regimens are tightly associated with increases in treatment compliance and depend on the epidemiological background.
authors.affiliation: Instituto de Física, Universidade Federal da Bahia, Campus Universitário de Ondina, 40210-340, Salvador, Brazil. Electronic address: suani@ufba.br.
authors.forename: S T R
authors.initials: ST
authors.lastname: Pinho
authors.affiliation: Departamento de Matemática and Centro de Matemática e Aplicações, Universidade Nova de Lisboa, Quinta da Torre, 2829-516, Caparica, Portugal. Electronic address: pcpr@fct.unl.pt.
authors.forename: P
authors.initials: P
authors.lastname: Rodrigues
authors.affiliation: Instituto de Física, Universidade Federal da Bahia, Campus Universitário de Ondina, 40210-340, Salvador, Brazil. Electronic address: randrade@ufba.br.
authors.forename: R F S
authors.initials: RF
authors.lastname: Andrade
authors.affiliation: Faculdade de Educação, Universidade Federal da Grande Dourados, Rodovia Dourados, Itahum, km 12, 79804-070 - Dourados, Brazil. Electronic address: hiraldoserra@ufgd.edu.br.
authors.forename: H
authors.initials: H
authors.lastname: Serra
authors.affiliation: Instituto Gulbenkian de Ciência, Oeiras, Portugal. Electronic address: jmlopes@igc.pt.
authors.forename: J S
authors.initials: JS
authors.lastname: Lopes
authors.affiliation: Instituto Gulbenkian de Ciência, Oeiras, Portugal. Electronic address: ggomes@igc.pt.
authors.forename: M G M
authors.initials: MG
authors.lastname: Gomes
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D006801:Humans; D055118:Medication Adherence; D008954:Models, Biological; D014376:Tuberculosis / Q000188:drug therapy* / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents
keywords: Default; Mathematical model; Reinfection; Treatment; Tuberculosis