Assessing the transmission risk of multidrug-resistant Mycobacterium tuberculosis epidemics in regions of Taiwan

SummaryObjectiveThe objective of this study was to link transmission dynamics with a probabilistic risk model to provide a mechanistically explicit assessment for estimating the multidrug-resistant tuberculosis (MDR TB) infection risk in regions of Taiwan.MethodsA relative fitness (RF)-based MDR TB model was used to describe transmission, validated with disease data for the period 2006–2010. A dose–response model quantifying by basic reproduction number (R0) and total proportion of infected population was constructed to estimate the site-specific MDR TB infection risk.ResultsWe found that the incidence rate of MDR TB was highest in Hwalien County (4.91 per 100 000 population) in eastern Taiwan, with drug-sensitive and multidrug-resistant R0 estimates of 0.89 (95% CI 0.23–2.17) and 0.38 (95% CI 0.05–1.30), respectively. The predictions were in apparent agreement with observed data in the 95% credible intervals. Our simulation showed that the incidence of MDR TB will be falling by 2013–2016. Our results indicated that the selected regions of Taiwan had only ∼1% probability of exceeding 50% of the population with infection attributed to MDR TB.ConclusionsOur study found that the ongoing control programs implemented in Taiwan may succeed in curing most patients with MDR TB and will reduce the TB incidence countrywide.