Despite renewed attention to tuberculosis (TB) control in the last decade, ongoing TB treatment programs are not evaluated by the impact they may be having on the local or global epidemiology of TB. Currently, the emergence of costly- and difficult-to-treat multidrug- resistant strains of M. tuberculosis threatens recent gains in TB control. This doctoral thesis project has been designed to respond to gaps in current knowledge regarding the likely impact of ongoing TB control strategies, and the potential epidemiological and economic benefits of alternative strategies. The data collection process will consist of a household survey of 3,000 individuals conducted in a poor community of northern Lima, Peru. This survey data will be used to estimate the size, and the average duration of infectiousness, of several different groups of TB cases, including those who have multidrug-resistant TB. This data will be coupled with mathematical models of the transmission dynamics of TB, in order to compare ongoing and alternative local TB treatment and control strategies, with the purpose of informing global TB control policy. The data collection, analysis, and writing for the doctoral thesis research project will be completed by June 1999.
