The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy
Autor(a) principal: | |
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Data de Publicação: | 2004 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.7/54 |
Resumo: | Population patterns of infection are determined largely by susceptibility to infection. Infection and vaccination induce an immune response that, typically, reduces susceptibility to subsequent infections. With a general epidemic model, we detect a 'reinfection threshold', above which reinfection is the principal type of transmission and, consequently, infection levels are much higher and vaccination fails. The model is further developed to address human tuberculosis (TB) and the impact of vaccination. The bacille Calmette-Guérin (BCG) is the only vaccine in current use against TB, and there is no consensus about its usefulness. Estimates of protection range from 0 to 80%, and this variability is aggravated by an association between low vaccine efficacy and high prevalence of the disease. We propose an explanation based on three postulates: (i) the potential for transmission varies between populations, owing to differences in socio-economic and environmental factors; (ii) exposure to mycobacteria induces an immune response that is partially protective against reinfection; and (iii) this protection is not significantly improved by BCG vaccination. These postulates combine to reproduce the observed trends, and this is attributed to a reinfection threshold intrinsic to the transmission dynamics. Finally, we demonstrate how reinfection thresholds can be manipulated by vaccination programmes, suggesting that they have a potentially powerful role in global control |
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The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacyModels, Biologicalycobacterium Infections/immunologyDisease Transmission, Infectious/prevention & controlTuberculosis/epidemiologyTuberculosis/immunologyTuberculosis/transmissionPopulation patterns of infection are determined largely by susceptibility to infection. Infection and vaccination induce an immune response that, typically, reduces susceptibility to subsequent infections. With a general epidemic model, we detect a 'reinfection threshold', above which reinfection is the principal type of transmission and, consequently, infection levels are much higher and vaccination fails. The model is further developed to address human tuberculosis (TB) and the impact of vaccination. The bacille Calmette-Guérin (BCG) is the only vaccine in current use against TB, and there is no consensus about its usefulness. Estimates of protection range from 0 to 80%, and this variability is aggravated by an association between low vaccine efficacy and high prevalence of the disease. We propose an explanation based on three postulates: (i) the potential for transmission varies between populations, owing to differences in socio-economic and environmental factors; (ii) exposure to mycobacteria induces an immune response that is partially protective against reinfection; and (iii) this protection is not significantly improved by BCG vaccination. These postulates combine to reproduce the observed trends, and this is attributed to a reinfection threshold intrinsic to the transmission dynamics. Finally, we demonstrate how reinfection thresholds can be manipulated by vaccination programmes, suggesting that they have a potentially powerful role in global controlProceedings. Biological sciences, R.S.ARCAGomes, M. G. M.Franco, A. O.Gomes, M. C.Medley, G. F.2009-10-08T15:09:11Z20042004-032009-10-08T15:09:12Z2004-03-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.7/54engGomes, M.G., Franco, A.O., Gomes, M.C., Medley, G.F.(2004)."The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy".Proceedings. Biological sciences, R.S. 271(1539):617-230962-8452info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-11-29T14:34:36Zoai:arca.igc.gulbenkian.pt:10400.7/54Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:11:33.113931Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
title |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
spellingShingle |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy Gomes, M. G. M. Models, Biological ycobacterium Infections/immunology Disease Transmission, Infectious/prevention & control Tuberculosis/epidemiology Tuberculosis/immunology Tuberculosis/transmission |
title_short |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
title_full |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
title_fullStr |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
title_full_unstemmed |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
title_sort |
The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy |
author |
Gomes, M. G. M. |
author_facet |
Gomes, M. G. M. Franco, A. O. Gomes, M. C. Medley, G. F. |
author_role |
author |
author2 |
Franco, A. O. Gomes, M. C. Medley, G. F. |
author2_role |
author author author |
dc.contributor.none.fl_str_mv |
Proceedings. Biological sciences, R.S. ARCA |
dc.contributor.author.fl_str_mv |
Gomes, M. G. M. Franco, A. O. Gomes, M. C. Medley, G. F. |
dc.subject.por.fl_str_mv |
Models, Biological ycobacterium Infections/immunology Disease Transmission, Infectious/prevention & control Tuberculosis/epidemiology Tuberculosis/immunology Tuberculosis/transmission |
topic |
Models, Biological ycobacterium Infections/immunology Disease Transmission, Infectious/prevention & control Tuberculosis/epidemiology Tuberculosis/immunology Tuberculosis/transmission |
description |
Population patterns of infection are determined largely by susceptibility to infection. Infection and vaccination induce an immune response that, typically, reduces susceptibility to subsequent infections. With a general epidemic model, we detect a 'reinfection threshold', above which reinfection is the principal type of transmission and, consequently, infection levels are much higher and vaccination fails. The model is further developed to address human tuberculosis (TB) and the impact of vaccination. The bacille Calmette-Guérin (BCG) is the only vaccine in current use against TB, and there is no consensus about its usefulness. Estimates of protection range from 0 to 80%, and this variability is aggravated by an association between low vaccine efficacy and high prevalence of the disease. We propose an explanation based on three postulates: (i) the potential for transmission varies between populations, owing to differences in socio-economic and environmental factors; (ii) exposure to mycobacteria induces an immune response that is partially protective against reinfection; and (iii) this protection is not significantly improved by BCG vaccination. These postulates combine to reproduce the observed trends, and this is attributed to a reinfection threshold intrinsic to the transmission dynamics. Finally, we demonstrate how reinfection thresholds can be manipulated by vaccination programmes, suggesting that they have a potentially powerful role in global control |
publishDate |
2004 |
dc.date.none.fl_str_mv |
2004 2004-03 2004-03-01T00:00:00Z 2009-10-08T15:09:11Z 2009-10-08T15:09:12Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.7/54 |
url |
http://hdl.handle.net/10400.7/54 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Gomes, M.G., Franco, A.O., Gomes, M.C., Medley, G.F.(2004)."The reinfection threshold promotes variability in tuberculosis epidemiology and vaccine efficacy".Proceedings. Biological sciences, R.S. 271(1539):617-23 0962-8452 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799130571393204224 |