Little is known about the dynamics of the early stages of untreated active pulmonary tuberculosis:unknown are both the rates of progression and the model“scheme”.The“parallel”scheme assumes that infectiousness of ...Little is known about the dynamics of the early stages of untreated active pulmonary tuberculosis:unknown are both the rates of progression and the model“scheme”.The“parallel”scheme assumes that infectiousness of tuberculosis cases is effectively predefined at the onset of the disease,and the“serial”scheme considers all cases to be noninfectious at the onset,with some of them later becoming infectious.Our aim was to estimate the progression of the early stages of pulmonary tuberculosis using data from a present-day population.We used the routine notification data from Moscow,Russia,2013e2018 that contained the results and time of the last fluorographic screening preceding the detection of tuberculosis cases.This provided time limits on the duration of untreated tuberculosis.Parameters of TB progression under both models were estimated.By the goodness of fit to the data,we could prefer neither the“parallel”,nor the“serial”model,although the latter had a bit worse fit.On the other hand,the observed rise in the fraction of infectious tuberculosis cases with the time since the last screening was explained by the“serial”model in a more plausible way e as gradual progression of some cases to infectiousness.The“parallel”model explained it through less realistic quick removal of non-infectious cases and accumulation of the infectious ones.The results demonstrate the potential of using such detection data enriched with reassessments of the previous screenings.展开更多
基金KKA and AAR were supported by the Moscow Center of Fundamental and Applied Mathematics(Agreement 075-15-2019-1624 with the Ministry of Education and Science of the Russian Federation)https://mathcenter.ru/en/.EMB and SEB were supported by research project No.AAAA-A20-120062990040-100Development of a program for expanded access to tuberculosis control measures for the population of the city of Moscow:medical,social and economic justification”funded by the Department of Health of the Moscow Government,https://mosgorzdrav.ru/en-US/index.html。
文摘Little is known about the dynamics of the early stages of untreated active pulmonary tuberculosis:unknown are both the rates of progression and the model“scheme”.The“parallel”scheme assumes that infectiousness of tuberculosis cases is effectively predefined at the onset of the disease,and the“serial”scheme considers all cases to be noninfectious at the onset,with some of them later becoming infectious.Our aim was to estimate the progression of the early stages of pulmonary tuberculosis using data from a present-day population.We used the routine notification data from Moscow,Russia,2013e2018 that contained the results and time of the last fluorographic screening preceding the detection of tuberculosis cases.This provided time limits on the duration of untreated tuberculosis.Parameters of TB progression under both models were estimated.By the goodness of fit to the data,we could prefer neither the“parallel”,nor the“serial”model,although the latter had a bit worse fit.On the other hand,the observed rise in the fraction of infectious tuberculosis cases with the time since the last screening was explained by the“serial”model in a more plausible way e as gradual progression of some cases to infectiousness.The“parallel”model explained it through less realistic quick removal of non-infectious cases and accumulation of the infectious ones.The results demonstrate the potential of using such detection data enriched with reassessments of the previous screenings.
