Tuberculosis in Ethiopia: Optimal Intervention Strategies and Cost-Effectiveness Analysis

Abstract

This paper searches for optimal strategies for the minimization of the number of high-risk latent and active tuberculosis (TB) infectious individuals using real data from Ethiopia. Optimal control theory is harnessed for investigation and analysis of the optimal combination of interventions for controlling the transmission of TB using distancing, case finding, and case holding as controls. We calculate and compare the incremental cost-effectiveness ratio (ICER) for each of the strategies to determine the most effective combination of interventions for curbing the spread of the disease. Our findings suggest that, for optimal cost-effective management of the TB disease, the government of Ethiopia must focus more on prevention strategies such as isolation of infectious people, early TB patient detection, treatment, and educational programs. The optimal strategy is quantified through simulation.

Keywords

• tuberculosis
• TB detection
• social distancing
• isolation
• incremental cost-effectiveness ratio