monitoring linked epidemics the case of tuberculosis and hiv监测流行肺结核和艾滋病的情况有关.pdfVIP

Monitoring Linked Epidemics: The Case of Tuberculosis and HIV ´ ´ 1 2 1 Marıa S. Sanchez *, James O. Lloyd-Smith , Wayne M. Getz 1 Department of Environmental Science, Policy and Management, University of California, Berkeley, California, United States of America, 2 Department of Ecology and Evolutionary Biology, University of California Los Angeles, Los Angeles, California, United States of America Abstract Background: The tight epidemiological coupling between HIV and its associated opportunistic infections leads to challenges and opportunities for disease surveillance. Methodology/Principal Findings: We review efforts of WHO and collaborating agencies to track and fight the TB/HIV co- epidemic, and discuss modeling—via mathematical, statistical, and computational approaches—as a means to identify disease indicators designed to integrate data from linked diseases in order to characterize how co-epidemics change in time and space. We present RTB/HIV, an index comparing changes in TB incidence relative to HIV prevalence, and use it to identify those sub-Saharan African countries with outlier TB/HIV dynamics. RTB/HIV can also be used to predict epidemiological trends, investigate the coherency of reported trends, and cross-check the anticipated impact of public health interventions. Identifying the cause(s) responsible for anomalous RTB/HIV values can reveal information crucial to the management of public health. Conclusions/Significance: We frame our suggestions for integrating and analyzing co-epidemic data within the context of global disease monitoring. Used routinely, joint disease indicators such as RTB/HIV could greatly enhance the monitoring and evaluation of public h