Designing and Evaluating Interventions to Halt the Transmission of Tuberculosis
Open Access
- 1 October 2017
- journal article
- review article
- Published by Oxford University Press (OUP) in The Journal of Infectious Diseases
- Vol. 216 (suppl_6), S654-S661
- https://doi.org/10.1093/infdis/jix320
Abstract
To reduce the incidence of tuberculosis, it is insufficient to simply understand the dynamics of tuberculosis transmission. Rather, we must design and rigorously evaluate interventions to halt transmission, prioritizing those interventions most likely to achieve population-level impact. Synergy in reducing tuberculosis transmission may be attainable by combining interventions that shrink the reservoir of latent Mycobacterium tuberculosis infection (preventive therapy), shorten the time between disease onset and treatment initiation (case finding and diagnosis), and prevent transmission in key settings, such as the built environment (infection control). In evaluating efficacy and estimating population-level impact, cluster-randomized trials and mechanistic models play particularly prominent roles. Historical and contemporary evidence suggests that effective public health interventions can halt tuberculosis transmission, but an evidence-based approach based on knowledge of local epidemiology is necessary for success. We provide a roadmap for designing, evaluating, and modeling interventions to interrupt the process of transmission that fuels a diverse array of tuberculosis epidemics worldwide.Keywords
Funding Information
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases
This publication has 55 references indexed in Scilit:
- Ultraviolet Germicidal Irradiation: Future Directions for Air Disinfection and Building ApplicationsPhotochemistry and Photobiology, 2013
- Is Passive Diagnosis Enough?American Journal of Respiratory and Critical Care Medicine, 2013
- Surgical Face Masks Worn by Patients with Multidrug-Resistant TuberculosisAmerican Journal of Respiratory and Critical Care Medicine, 2012
- Antiretroviral Program Associated with Reduction in Untreated Prevalent Tuberculosis in a South African TownshipAmerican Journal of Respiratory and Critical Care Medicine, 2010
- Comparison of two active case-finding strategies for community-based diagnosis of symptomatic smear-positive tuberculosis and control of infectious tuberculosis in Harare, Zimbabwe (DETECTB): a cluster-randomised trialThe Lancet, 2010
- Upper-Room Ultraviolet Light and Negative Air Ionization to Prevent Tuberculosis TransmissionPLoS Medicine, 2009
- Alternatives to randomisation in the evaluation of public health interventions: design challenges and solutionsJournal of Epidemiology and Community Health, 2009
- 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care SettingsAmerican Journal of Infection Control, 2007
- Natural Ventilation for the Prevention of Airborne ContagionPLoS Medicine, 2007
- Isoniazid for preventing tuberculosis in non-HIV infected personsEmergencias, 1999