A threshold value for the time delay to TB diagnosis

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dc.contributor.authorUys, Pieter W.
dc.contributor.authorWarren, Robin M.
dc.contributor.authorVan Helden, Paul D.
dc.date.accessioned2011-05-15T16:00:17Z
dc.date.available2011-05-15T16:00:17Z
dc.date.issued2007-08
dc.descriptionThe original publication is available at http:/www.plosone.org
dc.descriptionIncludes bibliography
dc.description.abstractBackgound. In many communities where TB occurs at high incidence, the major force driving the epidemic is transmission. It is plausible that the typical long delay from the onset of infectious disease to diagnosis and commencement of treatment is almost certainly the major factor contributing to the high rate of transmission. Methodology/Principal Findings. This study is confined to communities which are epidemiologically relatively isolated and which have low HIV incidence. The consequences of delays to diagnosis are analyzed and the existence of a threshold delay value is demonstrated. It is shown that unless a sufficient number of cases are detected before this threshold, the epidemic will escalate. The method used for the analysis avoids the standard computer integration of systems of differential equations since the intention is to present a line of reasoning that reveals the essential dynamics of an epidemic in an intuitively clear way that is nevertheless quantitatively realistic. Conclusions/Significance. The analysis presented here shows that typical delays to diagnosis present a major obstacle to the control of a TB epidemic. Control can be achieved by optimizing the rapid identification of TB cases together with measures to increase the threshold value. A calculated and aggressive program is therefore necessary in order to bring about a reduction in the prevalence of TB in a community by decreasing the time to diagnosis in all its ramifications. Intervention strategies to increase the threshold value relative to the time to diagnosis and which thereby decrease disease incidence are discussed. © 2007 Uys et al.en_ZA
dc.description.versionPublishers' Version
dc.format.extent6 p. : ill.
dc.identifier.citationUys, P. W., Warren, R. M., & Van Helden, P. D. 2007. A threshold value for the time delay to TB diagnosis. PLoS ONE, 2(8), e757, doi:10.1371/journal.pone.0000757.
dc.identifier.issn1932-6203 (online)
dc.identifier.otherdoi:10.1371/journal.pone.0000757
dc.identifier.urihttp://hdl.handle.net/10019.1/11621
dc.publisherPublic Library of Science (PLOS)
dc.rights.holderAuthors retain the copyright
dc.subjectarticleen_ZA
dc.subjectBacterial transmissionen_ZA
dc.subjectTuberculosis -- Effect of delayed diagnosis onen_ZA
dc.subjectBacterial epidemicen_ZA
dc.subjectTyberculosis -- Effect of human immunodeficiency virus infection onen_ZA
dc.subjectProcess optimizationen_ZA
dc.subjectTuberculosisen_ZA
dc.subjectTuberculosis -- Transmissionen_ZA
dc.titleA threshold value for the time delay to TB diagnosisen_ZA
dc.typeArticleen_ZA
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