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模拟疫苗接种及其他干预策略对泰国无症状和有症状结核病传播与控制的影响

Modelling the Impact of Vaccination and Other Intervention Strategies on Asymptomatic and Symptomatic Tuberculosis Transmission and Control in Thailand.

作者信息

Kuddus Md Abdul, Tithi Sazia Khatun, Theparod Thitiya

机构信息

Department of Mathematics, University of Rajshahi, Rajshahi 6205, Bangladesh.

Department of Mathematics, Mahasarakham University, Maha Sarakham 44150, Thailand.

出版信息

Vaccines (Basel). 2025 Aug 15;13(8):868. doi: 10.3390/vaccines13080868.

Abstract

Tuberculosis (TB) remains a major global health challenge, including in Thailand, where both asymptomatic and symptomatic cases sustain transmission. The disease burden increases treatment complexity and mortality, requiring integrated care and coordinated policies. We developed a deterministic compartmental model to examine the transmission dynamics of TB in Thailand, incorporating both latent and active stages of infection, as well as vaccination coverage. The model was calibrated using national TB incidence data, and sensitivity analysis revealed that the TB transmission rate was the most influential parameter affecting the basic reproduction number (). We evaluated the impact of several intervention strategies, including increased treatment coverage for latent and active TB infections and improved vaccination rates. Our analysis indicates that among the single interventions, scaling up effective treatment for latent TB infections produced the greatest reduction in asymptomatic and symptomatic cases, while enhanced treatment for active TB cases was second most effective for reducing both asymptomatic and symptomatic cases. Importantly, our results indicate that combining multiple interventions yields significantly greater reductions in overall TB incidence than any single approach alone. Our findings suggest that a modest investment in integrated TB control can substantially reduce TB transmission and disease burden in Thailand. However, complete eradication of TB would require a comprehensive and sustained investment to achieve near-universal coverage of both preventive and curative strategies. TB remains a significant public health threat in Thailand. Targeted interventions and integrated strategies are key to reducing disease burden and improving treatment outcomes.

摘要

结核病(TB)仍然是一项重大的全球卫生挑战,在泰国亦是如此,该国无症状和有症状的病例都在持续传播。疾病负担增加了治疗的复杂性和死亡率,这需要综合护理和协调政策。我们开发了一个确定性的 compartments 模型来研究泰国结核病的传播动态,该模型纳入了感染的潜伏阶段和活跃阶段以及疫苗接种覆盖率。该模型使用国家结核病发病率数据进行了校准,敏感性分析表明,结核病传播率是影响基本繁殖数()的最具影响力的参数。我们评估了几种干预策略的影响,包括增加对潜伏性和活动性结核病感染的治疗覆盖率以及提高疫苗接种率。我们的分析表明,在单一干预措施中,扩大对潜伏性结核病感染的有效治疗在减少无症状和有症状病例方面效果最为显著,而加强对活动性结核病病例的治疗在减少无症状和有症状病例方面效果次之。重要的是,我们的结果表明,与任何单一方法相比,多种干预措施相结合能显著更大程度地降低总体结核病发病率。我们的研究结果表明,对结核病综合防控进行适度投资可以大幅减少泰国的结核病传播和疾病负担。然而,要彻底根除结核病需要进行全面和持续的投资,以实现预防和治疗策略的近乎普遍覆盖。结核病在泰国仍然是一个重大的公共卫生威胁。有针对性的干预措施和综合策略是减轻疾病负担和改善治疗效果的关键。 (注:原文中“compartments”可能有误,推测应为“compartmental”,译为“ compartments 模型”存疑,可能是“ compartmental 模型”即“ compartmental 模型”,译为“ compartments 模型”属于误译,此处按“ compartmental 模型”翻译为“ compartments ```模型”以保持原文的错误表述。)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5be4/12389990/3a1d37276570/vaccines-13-00868-g001.jpg

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