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Could changes in national tuberculosis vaccination policies be ill-informed ?

Published online by Cambridge University Press:  06 June 2012

D.J. Gerberry  and
F.A. Milner
D.J. Gerberry*
Affiliation:
Department of Mathematics and Computer Science, Xavier University, 3800 Victory Parkway, Cincinnati, Ohio 45207, USA
F.A. Milner
Affiliation:
School of Mathematical and Statistical Sciences, Arizona State University, P.O. Box 871804, Tempe, Arizona 85287, USA
*
⋆ Corresponding author. E-mail: david.gerberry@xavier.edu
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Abstract

National policies regarding the BCG vaccine for tuberculosis vary greatly throughout the international community and several countries are currently considering discontinuing universal vaccination. Detractors of BCG point to its uncertain effectiveness and its interference with the detection and treatment of latent tuberculosis infection (LTBI).

In order to quantify the trade-off between vaccination and treatment of LTBI, a mathematical model was designed and calibrated to data from Brazil, Ghana, Germany, India, Mexico, Romania, the United Kingdom and the United States. Country-specific thresholds for when LTBI treatment outperforms mass vaccination were found and the consequences of policy changes were estimated.

Our results suggest that vaccination outperforms LTBI treatment in all settings but with greatly reduced efficiency in low incidence countries. While national policy statements emphasize BCG’s interference with LTBI detection, we find that reinfection should be more determinant of a country’s proper policy choice.

Keywords

tuberculosisBCGvaccinationmathematical modelingthreshold analysislatent tuberculosis detectionlatent tuberculosis treatment
Type
Research Article
Information
Mathematical Modelling of Natural Phenomena , Volume 7 , Issue 3: Epidemiology , 2012 , pp. 78 - 98
Copyright
© EDP Sciences, 2012

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References

Centers for Disease Control and Prevention. TB Elimination : Treatment of Latent Tuberculosis Infection (LTBI) July 2007. Accessed March 25, 2009 from : http://cdc.gov/TB/pubs/tbfactsheets/treatmentLTBI.pdf
World Health Organization. WHO position paper on BCG vaccination. Weekly Epidemiological Record, 79(4) :27–38, January 2004. Accessed on May 5, 2008 from : http://www.who.int/wer
Centers for Disease Control and Prevention. The role of BCG vaccine in the prevention and control of tuberculosis in the United States. Morbidity and Mortality Weekly Report : Recommendations and Reports, 45(RR-4), 1996.
World Health Organization. Global Tuberculosis Database, 2008. Accessed March 12, 2009 from : http://www.who.int/tb/country/global_tb_database/en/
World Health Organization, Department of Immunization, Vaccines and Biologicals. WHO vaccine-preventable diseases : monitoring system. 2007 Global Summary, 2007. Accessed on March 12, 2009 from : http://whqlibdoc.who.int/hq/2007/who_ivb_2007_eng.pdf
United States Census Bureau, Population Division. International Data Base, Decemeber 15, 2008. Accessed Jan 9, 2009 from http://www.census.gov/ipc/www/idb/index.html
Ziv, E., Daley, C.L., and Blower, S.M.. Potential public health impact of new tuberculosis vaccines. Emerg. Inf. Dis. 10(9) :1529–1535, September 2004. Google Scholar
Cohen, Ted, Colijn, Caroline, Finklea, Bryson, and Murray, Megan. Exogenous re-infection and the dynamics of tuberculosis epidemics : local effects in a network model for transmission. J. R. Soc. Interface, 4 :523–531, 2007. Google Scholar
P.G. Smith and A.R. Moss. Tuberculosis : Pathogenesis, Protection, and Control, chapter Epidemiology of tuberculosis. ASM Press, 1994.
Smith, D., Wiegeshaus, E., and Balasubramanian, V.. An analysis of some hypothesis related to the Chingelput Bacille Calmette-Guérin trial. Clinical Infectious Diseases, 31 (Suppl 3) :S77–80, 2000. Google Scholar
Gomes, M.G.M., Franco, A.O., Gomes, M.C., Medley, G.F.. The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficay. Proc. R. Soc. Lond. B, 271 :617–623, 2004. Google Scholar
Menzies, D.. What does tuberculin reactivity after Bacille Calmette-Guèrin vaccination tell us ? Clinical Infectious Diseases, 31(Suppl 3) :S71–4, 2000. Google ScholarPubMed
Menzies, R.I. and Vissandjee, B.. Effect of Bacille Calmette-Guérin vaccination on tuberculin reactivity. Am. Rev. Respir. Dis., 145 :621–5, 1992. Google ScholarPubMed
Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection. Morbidity and Mortality Weekly Report : Recommendations and Reports, 49(RR-6) :1–54, 2000.
García-Sancho, F. Ma. Cecilia, García-García, Lourdes, Jiménez-Corona, Ma. Eugenia, Palacios-Martínez, Manuel, Ferreyra-Reyes, Leticia D., Canizales-Quintero, Sergio, Cano-Arellano, Bulmaro, Ponce de León, Alfredo, Sifuentes-Osornio, José, Small, Peter, and DeRiemer, Kathryn. Is tuberculin skin testing useful to diagnose latent tuberculosis in BCG-vaccinated children ? International Journal of Epidemiology, 35 :1447–1454, 2006. Google Scholar
Gryzbowski, S., Barnett, G.D., and Styblo, K. Contact case of active pulmonary tuberculosis. International Union against Tuberculosis, 50(1) :90–106, Mar 1975. Google Scholar
Joos, T.J., Miller, W.C., and Murdoch, D.M.. Tuberculin reactivity in bacille Calmette-Guérin vaccinated populations : a compilation of international data. Int J Tuberc Lung Dis, 10(8) :883–91, Aug 2006. Google ScholarPubMed
Ling, D.-L., Liaw, Y.-P., Lee, C.-Y., Lo, H.-Y., Yang, H.-L., and Chan, P.-C.. Contact investigation for tuberculosis in taiwan contacts aged under 20 years in 2005. Int J Tuberc Lung Dis, 15(1) :50–5, Jan 2011. Google Scholar
Musoke Mudido, P., Guwatudde, D., Nakakeeto, M.K., Bukenya, G.B., Nsamba, D., Johnson, J.L., Mugerwa, R.D., Ellner, J.J., and Whalen, C.C.. The effect of bacille Calmette-Guérin vaccination at birth of tuberculin skin test reactivity in Ugandan children. Int. J. Tuberc. Lung Dis., 3(10) :891–895, 1999. Google Scholar
O Al-Orainey, Ibrahim. Diagnosis of latent tuberculosis : Can we do better ? Ann Thorac Med, 4(1) :5–9, Jan 2009. Google Scholar
Lalvani, Ajit and Pareek, Manish. A 100 year update on diagnosis of tuberculosis infection. British Medical Bulletin 93 :69–84, Jan 2010. Google ScholarPubMed
Oxlade, O., Schwartzman, K., and Menzies, D.. Interferon-gamma release assays and tb screening in high-income countries : a cost-effectiveness analysis. Int J Tuberc Lung Dis, 11(1) :16–26, Jan 2007. Google ScholarPubMed
Verver, S., Warren, R.M., Beyers, N., Richardson, M., van der Spuy, G.D., Borgdorff, M.W., Enarson, D.A., Behr, M.A., and Helden, P.D.. Rate of reinfection tuberculosis after successful treatment is higher than rate of new tuberculosis. Am. J. Respir. Crit. Care. Med., 171(12) :1324–5, June 2005. Google ScholarPubMed
Centers for Disease Control and Prevention. Reported Tuberculosis in the United States, 2007. Atlanta, GA, September 2008.
Gerberry, D.J.. Trade-off between bcg vaccination and the ability to detect and treat latent tuberculosis. Journal of Theoretical Biology, 261(4) :548–60, 2009. Google Scholar
Comstock, G.W., Livesay, V.T., and Woolpert, S.F.. The prognosis of a positive tuberculin reaction in childhood and adolescence. American Journal of Epidemiology, 99(2) :131–8, Feb 1974. Google ScholarPubMed
Frieden, Thomas R., Sterling, Timothy R., Munsiff, Sonal S., Watt, Catherine J., and Dye, Christopher. Tuberculosis. Lancet, 362 :887–899, 2003. Google ScholarPubMed
Young, Douglas and Dye, Christopher. The development and impact of tuberculosis vaccines. Cell, 124(4) :683–687, 2006. Google Scholar
Blower, S.M., McLean, A.R., Porco, T.C., Small, P.M., Hopewell, P.C., Sanchez, M.A., and Moss, A.R.. The intrinsic transmission dynamics of tuberculosis epidemics. Nature Medicine, 1(8) :815–821, August 1995. Google Scholar
Porco, T.C. and Blower, S.M.. Quantifying the intrinsic transmission dynamics of tuberculosis epidemics. Theoretical Population Biology, 54 :117–132, 1998. Google Scholar
Mayo Foundation for Medical Education and Research. Tuberculosis, Jan 28, 2009. Accessed May 21, 2009 from : http://www.mayoclinic.com/health/tuberculosis/DS00372/
Aronson, N.E., Santosham, M., Comstock, G.W., Howard, R.S., Moulton, L.H., Rhoades, E.R., and Harrison, L.H.. Long-term efficacy of BCG vaccine in American Indians and Alaska Natives : A 60-year follow-up study. JAMA, 291(17) :2086–2091, 2004. Google ScholarPubMed
Sterne, J.A.C., Rodrigues, L.C., and Guedes, I.N.. Does the efficacy of BCG decline with time since vaccination ? Int. J. Tuberc. Lung Dis., 2(3) :200–207, 1998. Google ScholarPubMed
Dye, Christopher, Garnett, Geoffrey P., Sleeman, Karen, and Williams, Brian G.. Prospects for worldwide tuberculosis control under the WHO DOTS strategy. The Lancet, 352 :1886–1891, 1998. Google ScholarPubMed
Dye, Christopher, Scheele, Suzanne, Dolin, Paul, Pathania, Vikram, and Raviglione, Mario C.. Global burden of tuberculosis : Estimated incidence, prevalence, and mortality by country. JAMA, 282 :677–686, 1999. Google Scholar
World Health Organization. Tuberculosis factsheet No. 104, March 2007. Accessed May 10, 2009 from : http://www.who.int/mediacentre/factsheets/fs104/en/index.html
Bennett, Diane E., Courval, Jeanne M., Onorato, Ida, Agerton, Tracy, Gibson, Judy D., Lambert, Lauren, McQuillan, Geraldine M., Lewis, Brenda, Navin, Thomas R., and Castro, Kenneth G.. Prevalence of tuberculosis infection in the United States population. Am. J. Respir. Crit. Care Med., 177 :348–355, 2008. Google ScholarPubMed
Sterling, Timothy R., Bethel, James, Goldberg, Stefan, Weinfurter, Paul, Yun, Lourdes, Horsburgh, C. Robert, and the Tuberculosis Epidemiologic Studies Consortium. The scope and and impact of treatment of latent tuberculosis infection in the United States and Canada. Am. J. Respir. Crit. Care Med., 173 :927–931, 2006. Google Scholar
Hesseling, Anneke C, Marais, Ben J, Gie, Robert P, Schaaf, H Simon, Fine, Paul E M, Godfrey-Faussett, Peter, and Beyers, Nulda. The risk of disseminated Bacille Calmette-Guerin (BCG) disease in HIV-infected children. Vaccine, 25(1) :14–8, Jan 2007. Google ScholarPubMed
World Health Organization. Revised BCG vaccination guidelines for children with HIV infection. pages 1–4, Apr 2007.
Elzinga, G., Raviglione, M.C., and Maher, D.. Scale up : meeting targets in global tuberculosis control. Lancet, 363 :814–819, 2004. Google ScholarPubMed