title: Improving Control of Tuberculosis in Low-Burden Countries: Insights from Mathematical Modeling.
abstract: Tuberculosis control and elimination remains a challenge for public health even in low-burden countries. New technology and novel approaches to case-finding, diagnosis, and treatment are causes for optimism but they need to be used cost-effectively. This in turn requires improved understanding of the epidemiology of TB and analysis of the effectiveness and cost-effectiveness of different interventions. We describe the contribution that mathematical modeling can make to understanding epidemiology and control of TB in different groups, guiding improved approaches to public health interventions. We emphasize that modeling is not a substitute for collecting data but rather is complementary to empirical research, helping determine what are the key questions to address to maximize the public-health impact of research, helping to plan studies, and making maximal use of available data, particularly from surveillance, and observational studies. We provide examples of how modeling and related empirical research inform policy and discuss how a combination of these approaches can be used to address current questions of key importance, including use of whole-genome sequencing, screening and treatment for latent infection, and combating drug resistance.
authors.affiliation: MRC Centre for Outbreak Analysis and Modelling and NIHR Health Protection Research Unit in Modelling Methodology, Imperial College London School of Public HealthLondon, UK; Modelling and Economics Unit, Centre for Infectious Disease Surveillance and Control, Public Health EnglandLondon, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: White
authors.affiliation: TB Section, Respiratory Diseases Department, Centre for Infectious Disease Surveillance and Control, Public Health EnglandLondon, UK; Research Department of Infection and Population Health, University College LondonLondon, UK; MRC Clinical Trials Unit, University College LondonLondon, UK.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Abubakar
keywords: MDR-TB; cost-effectiveness; health economics; health systems; latent TB infection; migrants; screening; transmission