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Background
Household contacts of people with pulmonary tuberculosis (TB) have greater risk of developing TB. Recent guidelines conditionally recommended TB preventive treatment (TPT) for household contacts of any age living in TB high-incidence countries, expanding earlier guidance to provide TPT to household contacts under five. The all-age population of household contacts has not been estimated.
Methods
Our model-based estimation included 20 countries with >80% of incident TB globally in 2019. We developed country-specific distributions of household composition by age and sex using bootstrap resampling from health surveys and census data. We incorporated age-, sex-, year-, and location-specific estimates of pulmonary TB incidence from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 to estimate the population in each country sharing a household with someone with incident pulmonary TB, and quantified uncertainty using a Monte Carlo approach.
Findings
We estimate that 38 million [95% uncertainty interval (UI) 33- 43 million] individuals lived in a household with someone with incident pulmonary TB in 2019 in these 20 countries. Children under five made up 12% of the population with household exposure, while adults were 65%. Zimbabwe, Mozambique, Zambia, and Pakistan had the highest proportion of the population with household exposure, while India had the highest number of contacts (11·4 million, 95% UI 9·7-13·4 million).
Interpretation
Expanding TPT evaluation to household contacts of all ages in high-incidence countries could include a population more than 7-times larger than the under-5 contacts previously prioritized. This would substantially increase the impact of household contact investigation on reducing TB morbidity and mortality.
Funding
JMR is supported by the National Institute of Allergy and Infectious Diseases (K01 AI138620). This research was funded in part by a 2020 developmental grant from the University of Washington / Fred Hutch Center for AIDS Research, an NIH funded program under award number AI027757 which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, NIDDK. This work was funded in part by the National Science Foundation (DMS-1839116).
There is a growing need of knowledge description of manufacturing equipment and their capabilities for users, in order to efficiently obtain the on-demand services of manufacturing equipment in cloud manufacturing, and the understanding of the manufacturing capability of equipment is the most important basis for optimizing the cloud service management. During the manufacturing processes, a number of uncertain incidents may occur, which could degrade the manufacturing system performance or even paralyze the production line. Hence, all aspects about the equipment should be reflected within the knowledge description, and the static and dynamic information are both included in the knowledge model of manufacturing equipment. Unification and dynamics are the most important characteristics of the framework of knowledge description. The primary work of this study is fourfold. First, three fundamental ontologies are built, namely, basic information ontology, functional ontology, and manufacturing process ontology. Second, the correlation between the equipment ontology and the fundamental ontology that forms the unified description framework is determined. Third, the mapping relationship between the real-time condition data and the model of manufacturing equipment capability ontology is established. On the basis of the mapping relationship, the knowledge structure of the manufacturing equipment capability ontology is able to update in real-time. Finally, a prototype system is developed to validate the feasibility of the proposed dynamic modeling method. The system implementation demonstrates that the proposed knowledge description framework and method are capable of reflecting the current conditions and the dynamic capability of manufacturing equipment.
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