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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Are survey-based estimates of the burden of drug resistant TB too low? Insight from a simulation study
PLoS ONE, Volume 3, No. 6, Article e2363, Year 2008
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Description
Background: The emergence of tuberculosis resistant to multiple first- and second-line antibiotics poses challenges to a global control strategy that relies on standard drug treatment regimens. Highly drug-resistant strains of Mycobacterium tuberculosis have been implicated in outbreaks and have been found throughout the world; a comprehensive understanding the magnitude of this threat require an accurate assessment of the worldwide burden of resistance. Unfortunately, in many settings where resistance is emerging, laboratory capacity is limited and estimates of the burden of resistance are obtained by performing drug sensitivity testing on a sample of incident cases rather than through the use of routine surveillance. Methodology/Principal Findings: Using an individual-based dynamic tuberculosis model to stimulate surveillance strategies for drug resistance, we found that current surveys may understimate the total burden of resistant tuberculosis because cases of acquired resistance are undercounted and resistance among prevalent cases is not assessed. We explored how this bias is affected by the maturity of the epidemic and by the introduction of interventions that target the emergence and spread of resistant tuberculosis. Conclusions: Estimates of drug resistant tuberculosis based on samples of incident cases should be viewed as a lower bound of the total burden of resistance. © 2008 Cohen et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2408555/bin/pone.0002363.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2408555/bin/pone.0002363.s002.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2408555/bin/pone.0002363.s003.tif
https://efashare.b-cdn.net/share/pmc/articles/PMC2408555/bin/pone.0002363.s004.tif
Authors & Co-Authors
Cohen, Ted
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard T.h. Chan School of Public Health
Colijn, Caroline
United States, Boston
Harvard T.h. Chan School of Public Health
Finklea, Bryson
United States, Boston
Harvard T.h. Chan School of Public Health
Wright, Abigail
Switzerland, Geneva
Organisation Mondiale de la Santé
Zignol, Matteo
Switzerland, Geneva
Organisation Mondiale de la Santé
Pym, Alexander S.
South Africa, Durban
Unit for Clinical and Biomedical tb Research
Murray, Megan B.
United States, Boston
Brigham and Women's Hospital
United States, Boston
Harvard T.h. Chan School of Public Health
United States, Boston
Massachusetts General Hospital
Statistics
Citations: 23
Authors: 7
Affiliations: 5
Identifiers
Doi:
10.1371/journal.pone.0002363
e-ISSN:
19326203
Research Areas
Infectious Diseases
Study Design
Cross Sectional Study
Study Approach
Quantitative