Modelling the global burden of drug-resistant tuberculosis avertable by a post-exposure vaccine

Nat Commun. 2021 Jan 18;12(1):424. doi: 10.1038/s41467-020-20731-x.

Abstract

There have been notable advances in the development of vaccines against active tuberculosis (TB) disease for adults and adolescents. Using mathematical models, we seek to estimate the potential impact of a post-exposure TB vaccine, having 50% efficacy in reducing active disease, on global rifampicin-resistant (RR-) TB burden. In 30 countries that together accounted for 90% of global RR-TB incidence in 2018, a future TB vaccine could avert 10% (95% credible interval: 9.7-11%) of RR-TB cases and 7.3% (6.6-8.1%) of deaths over 2020-2035, with India, China, Indonesia, Pakistan, and the Russian Federation having the greatest contribution. This impact would increase to 14% (12-16%) and 31% (29-33%) respectively, when combined with improvements in RR-TB diagnosis and treatment relative to a scenario of no vaccine and no such improvements. A future TB vaccine could have important implications for the global control of RR-TB, especially if implemented alongside enhancements in management of drug resistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / pharmacology*
  • Antitubercular Agents / therapeutic use
  • Computer Simulation
  • Drug Resistance, Bacterial / immunology
  • Global Burden of Disease*
  • Humans
  • Incidence
  • Models, Statistical
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / immunology
  • Mycobacterium tuberculosis / isolation & purification
  • Post-Exposure Prophylaxis / methods*
  • Rifampin / pharmacology
  • Rifampin / therapeutic use
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology*
  • Tuberculosis / microbiology
  • Tuberculosis / prevention & control
  • Tuberculosis Vaccines / administration & dosage*

Substances

  • Antitubercular Agents
  • Tuberculosis Vaccines
  • Rifampin