Bhadauria Archana Singh, Dhungana Hom Nath, Verma Vinay, Woodcock Stephen, Rai Tapan
Department of Mathematics and Statistics, Deen Dayal Upadhyaya Gorakhpur University, India.
School of Mathematical and Physical Sciences, University of Technology Sydney, Australia.
Infect Dis Model. 2023 Apr 6;8(2):458-470. doi: 10.1016/j.idm.2023.03.005. eCollection 2023 Jun.
India has the highest burden of both tuberculosis (TB) and multidrug-resistant TB (MDR-TB) based on the WHO Global TB Report 2019. Although the available data suggest that the total TB incidence has declined, the absolute number of new cases is still increasing. The number of reported TB cases in India in 2018 was 2.2 million, which was 1.5 million in 2009. About 47% increment in TB case notification in India within a decade shows a persistent public health problem. India contributes about 22% of the World's TB burden. Indian National Strategic Plan 2017-2025, sets out the government plans to eliminate TB by 2025. However, the milestone seems unrealistic to achieve the TB eradication goal by 2025. We developed a five-dimensional mathematical model to understand the TB dynamics in India and investigate the possibility of the earliest TB eradication time frame. The model stratifies the entire TB class into three different classes as drug-sensitive (DS), MDR, and isolated classes. The effective reproduction number, equilibrium points, and stability analysis of the model were carried out. This model predicts the total estimated cases of DS-TB and MDR-TB from 2018 to 2035 through numerical simulation and suggests that TB may be eliminated by 2035 in India if the treatment success rate could be achieved to 95%, by contact tracing and isolating at least 50% of MDR-TB.
根据《2019年世界卫生组织全球结核病报告》，印度的结核病（TB）和耐多药结核病（MDR-TB）负担最重。尽管现有数据表明结核病总发病率有所下降，但新病例的绝对数量仍在增加。2018年印度报告的结核病病例数为220万，2009年为150万。印度在十年内结核病病例通报量增加了约47%，这表明这是一个持续存在的公共卫生问题。印度的结核病负担约占全球的22%。《2017-2025年印度国家战略计划》列出了政府到2025年消除结核病的计划。然而，要在2025年实现消除结核病的目标，这一里程碑似乎不切实际。我们开发了一个五维数学模型来了解印度的结核病动态，并研究最早实现结核病消除的时间框架的可能性。该模型将整个结核病类别分为药物敏感（DS）、耐多药和孤立类别三类。对该模型进行了有效繁殖数、平衡点和稳定性分析。该模型通过数值模拟预测了2018年至2035年药物敏感结核病和耐多药结核病的估计病例总数，并表明如果治疗成功率能达到95%，通过接触者追踪并隔离至少50%的耐多药结核病患者，印度可能在2035年消除结核病。
