PARENT SESSION
Oral Session #30: Modeling.
Presiding: T. Day
Tuesday, August 6. 8:00 AM to 11:30 AM. Apache Meeting Room, TCC.
Spatial control of tuberculosis.
Duke-Sylvester, Scott*,1, Gross, Louis1, Salinas, Rene1, Purucker, Tom1, Joshi, Hem1, Harrell, Susan1, 1 University of Tennessee, Knoxville, TN
ABSTRACT- The development of resistance by infectious micro-organisms to antibiotics is a matter of global concern. Resistant pathogens present a significant health risk to humans in both developed and developing nations. Among the pathogens of concern is Mycobacterium tuberculosis (TB). A number of different techniques have been proposed to limit the buildup of resistance including drug cycling. In drug cycling patients are grouped based on when they became infected and all are treated with a single anti- microbial agent. In this way a single drug is used for all new infections that occur over some period of time. Individuals who become infected before or after fall into other groups which receive different single drug treatments. Several studies have reported the successful use of this approach to limit the development of resistance. We have developed a model of resistance dynamics for TB that incorporates drug cycling in a number of discrete populations connected through migration. This model is used in an optimal control framework that minimizes the total resistance through time and across all populations. This approach allows us to address two important questions. First, it is known from empirical work that drug cycling can limit the build up of resistance. Given this observation, what sequence of drug application provides the smallest buildup of resistance. Second, how does spatial structure effect the treatment plan, and is a spatially-structured treatment plan substantially better than a plan in which all regions receive the same sequence of treatment.
KEY WORDS: Mycobacterium tuberculosis, Spatial Control, Epidemiology, Modelling