Towards improved understanding of transmission dynamics of tuberculosis in The Gambia

All TB control strategies have a common goal: to reduce transmission and eventually contain the spread of TB within the population. However, assessing reduced transmission of TB is difficult, as results from molecular tools available to date have yet to be fully integrated in transmission models. Therefore, the main objective of this PhD project is to develop a model that incorporates bacterial genotyping/whole genome sequencing to follow TB transmission within the human host population. Integration of routine epidemiological and genotyping data with mathematical modelling provides a novel, powerful approach to understand the key determinants of the TB epidemic, such as the Effective Reproductive Number RE, and predict the dynamics of TB transmission. We have the unique opportunity to position the present proposal as an added-value study that builds on a 3-year population based Cluster Randomized Trial of Enhanced-Case-Finding (ECF) that was launched in The Gambia in March 2012. By applying molecular genotyping methods and whole genome sequencing to bacterial isolates collected from the study population, the student will develop a method to measure and model the TB transmission dynamics in intervention and control groups. This will be the first study of its kind integrating molecular genotyping data in a TB transmission model applied to a population level interventional study.