Evaluation of TB elimination strategies in Canadian Inuit populations:Nunavut as a case study

作     者：Elaheh Abdollahi Yoav Keynan Patrick Foucault Jason Brophy Holden Sheffield Seyed MMoghadas 

作者机构：Agent-Based Modelling LaboratoryYork UniversityM3J 1P3TorontoOntarioCanada Department of Medical MicrobiologyMax Rady College of MedicineUniversity of ManitobaWinnipegR3E 0T5ManitobaCanada National Collaborating Centre for Infectious DiseasesUniversity of ManitobaWinnipegR3E 0T5ManitobaCanada Department of Family MedicineQikiqtani General HospitalIqaluitX0A 0H0NunavutCanada Department of PediatricsUniversity of OttawaOttawaK1N 6N5OntarioCanada Department of PaediatricsQikiqtani General HospitalIqaluitX0A 0H0NunavutCanada 

出 版 物：《Infectious Disease Modelling》 (传染病建模（英文）)

年 卷 期：2022年第7卷第4期

页      面：698-708页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：support from Natural Sciences and Engineering Research Council of Canada through Individual Discovery Grant 

主　　题：Tuberculosis Inuit populations Treatment Agent-based simulation 2000 MSC 92B05 

摘      要：Tuberculosis(TB)continues to disproportionately affect Inuit populations in Canada with some communities having over 300 times higher rate of active TB than Canadian-born,non-Indigenous *** Tuberculosis Elimination Framework has set the goal of reducing active TB incidence by at least 50%by 2025,aiming to eliminate it by *** these goals are achievable with available resources and treatment regimens currently in practice has not been *** developed an agent-based model of TB transmission to evaluate timelines and milestones attainable in Nunavut,Canada by including case findings,contact-tracing and testing,treatment of latent TB infection(LTBI),and the government investment on housing infrastructure to reduce the average house-hold *** model was calibrated to ten years of TB incidence data,and simulated for 20 years to project program *** found that,under a range of plausible scenarios with tracing and testing of 25%e100%of frequent contacts of detected active cases,the goal of 50%reduction in annual incidence by 2025 is not *** active TB cases are identified rapidly within one week of becoming symptomatic,then the annual incidence would reduce below 100 per 100,000 population,with 50%reduction being met between 2025 and *** TB from Inuit populations would require high rates of contacttracing and would extend beyond *** findings indicate that time-to-identification of active TB is a critical factor determining program effectiveness,suggesting that investment in resources for rapid case detection is fundamental to controlling TB.