Can Australia eliminate TB? Modelling immigration strategies for reaching MDG targets in a low‐transmission setting. (4th February 2014)

• Record Type: Journal Article
• Authors: Denholm, Justin T.; McBryde, Emma S.
• Is Part Of: Australian and New Zealand journal of public health. Volume 38:Number 1(2014:Feb.)
• Page Start: 78
• Page End: 82
• Publication Date: 2014-02-04
• Subjects: Public health -- Australia -- Periodicals; Public health -- New Zealand -- Periodicals; Medical care -- Australia -- Periodicals; Medical care -- New Zealand -- Periodicals; 362.10993
• DOI: 10.1111/1753-6405.12161
• Languages: English
• ISSNs: 1326-0200

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <p> <bold>Background:</bold> The 2050 Millennium Development Goals (MDG) for tuberculosis (TB) aim for elimination of TB as a public health issue. We used a mathematical modelling approach to evaluate the feasibility of this target in a low‐prevalence setting with immigration‐related strategies directed at latent tuberculosis.</p> <p> <bold>Methods:</bold> We used a stochastic individual‐based model to simulate tuberculosis disease among immigrants to Victoria, Australia; a representative low‐transmission setting. A variety of screening and treatment approaches aimed at preventing reactivation of latent infection were applied to evaluate overall tuberculosis incidence reduction and rates of multidrug resistant disease.</p> <p> <bold>Results:</bold> Without additional intervention, tuberculosis incidence was predicted to reach 34.5 cases/million by 2050. Strategies involving the introduction of an available screening/treatment combination reduced TB incidence to between 16.9–23.8 cases/million, and required screening of 136–427 new arrivals for each case of TB prevented. Limiting screening to higher incidence regions of origin was less effective but more efficient.</p> <p> <bold>Conclusions:</bold> Public health strategies targeting latent tuberculosis infection in immigrants may substantially reduce tuberculosis incidence in a low prevalence region. However, immigration‐focused strategies cannot achieve the 2050 MDG and alternative or complementary approaches are required.</p> </abstract>