Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

TB incidence in Aboriginal communities is 20 to 50 times higher than that among Canadian-born non-Aboriginal peoples. The high incidence indicates that TB transmission is highly active in these communities. The probability of transmission and chances of new cases is increased if there is a long period between infection and treatment. Social and cultural factors and general lack of access to health care in Aboriginal communities have created a serious treatment delay. Long treatment delay combined with overcrowded housing and high mobility among reserves creates a real possibility for high transmission. Interventions that reduce treatment delays can have a significant and direct effect on incidence reduction. Mathematical modeling is an effective tool that can qualitatively and quantitatively assess impacts of different intervention strategies and help develop a comprehensive approach to TB control. The proposed research aims to: 1) develop mathematical models that help describe and understand TB transmission dynamics in Aboriginal communities; 2) use mathematical models integrated with real data to conduct cost-benefit analyses on potential intervention strategies; and 3) provide recommendations based on model outcomes to policy makers. Using mathematical models to address public health issues is an innovative method of approach. The proposed research is highly interdisciplinary and will be carried out in close collaboration with mathematical modellers and public health researchers. We expect the research will provide insight and recommendations for comprehensive TB control strategies for these communities. The interdisciplinary modeling approach developed from this project can be applied to investigate other infectious diseases and public health issues in Aboriginal communities.