On the Role of Early Case Detection and Treatment Failure in Controlling Tuberculosis Transmission: A Mathematical Modeling Study

Abstract

Tuberculosis (TB) remains a pressing global health concern, demanding urgent attention to mitigate its spread and impact. In this study, we present a rigorous mathematical model of TB transmission that incorporates early case detection and addresses the critical issue of treatment failure. Through the development of a system of nonlinear ordinary differential equations, we conduct comprehensive analyses to assess the dynamics of TB transmission and the efficacy of intervention strategies. Our findings underscore the urgent need for effective TB control measures. Mathematical analyses reveal that the model exhibits a TB-free equilibrium, which is globally asymptotically stable only if the control reproduction number falls below one. However, we identify a concerning phenomenon: the model demonstrates a forward bifurcation when the control reproduction number equals one, suggesting that the disease-free equilibrium loses its stability, while simultaneously, the stable unique endemic equilibrium begins to emerge. Moreover, sensitivity analysis highlights the complex interplay between case detection rates, treatment failure probabilities, and TB transmission dynamics. Contrary to expectations, increasing case detection rates and minimizing treatment failure probabilities may not consistently reduce the basic reproduction number or the size of the infected population. Instead, there exists a critical threshold for intervention effectiveness, beyond which TB transmission can be significantly curtailed. Biologically, this phenomenon may occur if there is no balance between case detection and treatment efforts. If treatment quality does not improve, then case detection will not have a significant impact, and in the worst case scenario, it can exacerbate the intervention’s negative effects. These findings underscore the urgency of implementing targeted intervention strategies to combat TB transmission effectively. Failure to meet the critical intervention threshold risks undermining TB elimination efforts and exacerbating the global TB burden. Through numerical simulations, we elucidate potential intervention scenarios necessary for achieving TB elimination goals in human populations. In conclusion, our study highlights the urgent imperative for coordinated action to control TB transmission effectively. By elucidating the dynamics of TB spread and intervention efficacy, we provide valuable insights to inform evidence-based policy decisions and accelerate progress towards TB elimination on a global scale.

Keywords

• tuberculosis
• case detection
• treatment failure
• control reproduction number
• bifurcation
• sensitivity analysis