Project - Transmission of tuberculosis in four key states
This effort seeks to develop a model that will project the impact of selected interventions for tuberculosis (TB), including the ability of those interventions to speed time to elimination, in the United States. Our approach begins with modeling the four key states responsible for over 50% of incident active TB in the US: California, New York, Florida, and Texas. These states differ from each other and the remainder of the US in a number of key variables, including overall TB incidence, percent of TB incidence in the foreign-born, and racial/ethnic makeup of cases. Modeling these four key states will enable us to explore whether these substantial differences in TB case makeup (as well as differences in migration, demographics, socioeconomic status, and projected prevalence of LTBI) translate into differences in the projected trajectory of TB, as well as the relative cost and impact of targeted TB interventions, in these states (compared to each other and relative to the remainder of the US). It will also allow us to estimate the impact of regionalized services (e.g., diagnostic testing) in these states, and the proportional contribution of these states to US TB elimination Working in collaboration with researchers at CDC and partners at UCSF and Harvard, this model will enable us to explore those differences in a single unified framework, thereby suggesting the best approach for constructing a final “official CDC” model of TB in the United States that accounts for important demographic trends as well as TB latency (and treatment thereof), immigration policies, and ongoing transmission. This project is conducted in partnership with scientists in the Division of Tuberculosis Elimination.
Modeling the Cost-effectiveness of Interventions to Eliminate Tuberculosis in Four States