Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection

There is significant disagreement in the epidemiological literatureregarding the extent to which reinfection of latently infected individuals contributes to the dynamics of tuberculosis (TB) epidemics. In this study wepresent an epidemiological model of Mycobacterium tuberculosis infection thatinclud...

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Main Authors: Benjamin H. Singer, Denise E. Kirschner
Format: Article
Language:English
Published: AIMS Press 2004-02-01
Series:Mathematical Biosciences and Engineering
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Online Access:https://www.aimspress.com/article/doi/10.3934/mbe.2004.1.81
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author Benjamin H. Singer
Denise E. Kirschner
author_facet Benjamin H. Singer
Denise E. Kirschner
author_sort Benjamin H. Singer
collection DOAJ
description There is significant disagreement in the epidemiological literatureregarding the extent to which reinfection of latently infected individuals contributes to the dynamics of tuberculosis (TB) epidemics. In this study wepresent an epidemiological model of Mycobacterium tuberculosis infection thatincludes the process of reinfection. Using analysis and numerical simulations,we observe the effect that varying levels of reinfection has on the qualitativedynamics of the TB epidemic. We examine cases of the model both withand without treatment of actively infected individuals. Next, we consider avariation of the model describing a heterogeneous population, stratified by susceptibility to TB infection. Results show that a threshold level of reinfectionexists in all cases of the model. Beyond this threshold, the dynamics of themodel are described by a backward bifurcation. Uncertainty analysis of theparameters shows that this threshold is too high to be attained in a realisticepidemic. However, we show that even for sub-threshold levels of reinfection,including reinfection in the model changes dynamic behavior of the model.In particular, when reinfection is present the basic reproductive number, $R_0$,does not accurately describe the severity of an epidemic.
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spelling doaj-art-853b0709f8a346759699f340914c47e52025-01-24T01:46:28ZengAIMS PressMathematical Biosciences and Engineering1551-00182004-02-0111819310.3934/mbe.2004.1.81Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfectionBenjamin H. Singer0Denise E. Kirschner1Department of Microbiology and Immunology, The University of Michigan Medical School, Ann Arbor, MI 48109-0620Department of Microbiology and Immunology, The University of Michigan Medical School, Ann Arbor, MI 48109-0620There is significant disagreement in the epidemiological literatureregarding the extent to which reinfection of latently infected individuals contributes to the dynamics of tuberculosis (TB) epidemics. In this study wepresent an epidemiological model of Mycobacterium tuberculosis infection thatincludes the process of reinfection. Using analysis and numerical simulations,we observe the effect that varying levels of reinfection has on the qualitativedynamics of the TB epidemic. We examine cases of the model both withand without treatment of actively infected individuals. Next, we consider avariation of the model describing a heterogeneous population, stratified by susceptibility to TB infection. Results show that a threshold level of reinfectionexists in all cases of the model. Beyond this threshold, the dynamics of themodel are described by a backward bifurcation. Uncertainty analysis of theparameters shows that this threshold is too high to be attained in a realisticepidemic. However, we show that even for sub-threshold levels of reinfection,including reinfection in the model changes dynamic behavior of the model.In particular, when reinfection is present the basic reproductive number, $R_0$,does not accurately describe the severity of an epidemic.https://www.aimspress.com/article/doi/10.3934/mbe.2004.1.81tbreinfectionheterogenous populations.backward bifurcationepidemicr0
spellingShingle Benjamin H. Singer
Denise E. Kirschner
Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
Mathematical Biosciences and Engineering
tb
reinfection
heterogenous populations.
backward bifurcation
epidemic
r0
title Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
title_full Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
title_fullStr Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
title_full_unstemmed Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
title_short Influence of backward bifurcation on interpretation of $R_0$ in a model of epidemic tuberculosis with reinfection
title_sort influence of backward bifurcation on interpretation of r 0 in a model of epidemic tuberculosis with reinfection
topic tb
reinfection
heterogenous populations.
backward bifurcation
epidemic
r0
url https://www.aimspress.com/article/doi/10.3934/mbe.2004.1.81
work_keys_str_mv AT benjaminhsinger influenceofbackwardbifurcationoninterpretationofr0inamodelofepidemictuberculosiswithreinfection
AT deniseekirschner influenceofbackwardbifurcationoninterpretationofr0inamodelofepidemictuberculosiswithreinfection