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

Infectious Disease Modelling 2022年第4期7卷 698-708页

作者： elaheh abdollahi Yoav Keynan Patrick Foucault Jason Brophy Holden Sheffield Seyed MMoghadas Agent-Based Modelling Laboratory York UniversityM3J 1P3TorontoOntarioCanada Department of Medical Microbiology Max Rady College of MedicineUniversity of ManitobaWinnipegR3E 0T5ManitobaCanada National Collaborating Centre for Infectious Diseases University of ManitobaWinnipegR3E 0T5ManitobaCanada Department of Family Medicine Qikiqtani General HospitalIqaluitX0A 0H0NunavutCanada Department of Pediatrics University of OttawaOttawaK1N 6N5OntarioCanada Department of Paediatrics Qikiqtani General HospitalIqaluitX0A 0H0NunavutCanada

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.

关键词： Tuberculosis Inuit populations Treatment Agent-based simulation 2000 MSC 92B05

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