Could changes in national tuberculosis vaccination policies be ill-informed ?

D. J. Gerberry, Fabio Milner

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

National policies regarding the BCG vaccine for tuberculosis vary greatly throughout the international community and several countries are currently considering discontinuing universal vaccination. Detractors of BCG point to its uncertain effectiveness and its interference with the detection and treatment of latent tuberculosis infection (LTBI). In order to quantify the trade-off between vaccination and treatment of LTBI, a mathematical model was designed and calibrated to data from Brazil, Ghana, Germany, India, Mexico, Romania, the United Kingdom and the United States. Country-specific thresholds for when LTBI treatment outperforms mass vaccination were found and the consequences of policy changes were estimated. Our results suggest that vaccination outperforms LTBI treatment in all settings but with greatly reduced efficiency in low incidence countries. While national policy statements emphasize BCG's interference with LTBI detection, we find that reinfection should be more determinant of a country's proper policy choice.

Original languageEnglish (US)
Pages (from-to)78-98
Number of pages21
JournalMathematical Modelling of Natural Phenomena
Volume7
Issue number3
DOIs
StatePublished - Jul 17 2012

Keywords

  • BCG
  • Latent tuberculosis detection
  • Latent tuberculosis treatment
  • Mathematical modeling
  • Threshold analysis
  • Tuberculosis
  • Vaccination

ASJC Scopus subject areas

  • Modeling and Simulation
  • Applied Mathematics

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