Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

IMPACT OF ISONIAZID FOR TUBERCULOSIS PREVENTION IN MALAYSIA: AN AGE-STRUCTURED MODEL

Author

Nurhuda Ismail 1,2 , Awang M. Bulgiba 2 , Nicolaas J.D. Nagelkerke 3, Omar Awang 4

Institution

1. University of Technology MARA Sungai Buloh Campus, Selangor, Malaysia
2. Julius Centre University of Malaya, Kuala Lumpur, Malaysia
3. United Arab Emirates University, Al-Ain, United Arab Emirates
4. University of Malaya, Kuala Lumpur, Malaysia

Abstract

Objectives: Tuberculosis remains as one of the highest unresolved disease burden in Malaysia for the last thirty years. With current treatment protocol emphasizing among the infectives, we seek to find if combination treatment of these active cases with Isoniazid preventive therapy among high risk latent tuberculosis population would give greater impact on reducing incidence.

Methods: We present a deterministic compartmental age-structured tuberculosis model which assumes latently infected individuals develop active disease resulting from primary infection, endogenous reactivation and exogenous reinfection. We analyze the model without any intervention and incorporate the preventive therapy and treatment of infectives. The reproduction numbers were compared to assess possible community benefits achieved by treatment of infectives, preventive therapy and combination of both strategies. The model further quantifies the effectiveness for early latent group and demonstrates how effective the therapy has to be to eliminate tuberculosis, when use in conjunction with treatment for active tuberculosis.

Results: Treatment of infectives is more effective in the first years of implementation of this preventive therapy as treatment results in clearing active tuberculosis immediately with reduced progression to infectious state.

Conclusion: Isoniazid Preventive Therapy which identify and treat persons recently infected may have substantial effect on controlling tuberculosis epidemics in Malaysia.