Age-structured Pulmonary TB dynamics and cost-effectiveness analysis in Korea

Objective: Tuberculosis(TB) is an infectious disease, causing more than 2000 deaths per year in Korea. Despite the effort of government, Korea still suffers from high mortality rate due to TB, ranking first among OECD countries. This study was aimed to evaluate the effect of close contact control strategies in different age groups and analyze cost-effectiveness of each control strategies.Method: An age-structured deterministic model was developed for the TB transmission in Korea. A SEIT (susceptible - exposed - infectious - treating) model was used with some additional compartments including 'high risk latent', 'low risk latent', and 'LTBI treated'. 15 different age groups were used to analyze different control strategies to different age group. Cost-effectiveness was analyzed using ICER through comparing incremental cost and incremental QALY by reducing number of TB patients.Result: The model suggested that close-contact control has the most effect in young age group(0-35). Expanding close-contact control will have mild effect on decreasing number of TB incidence every year, but decreasing the number of TB incidence by expanding close contact control does not guarantee cost-effectiveness in long term.