Heterogeneity in Tuberculosis infectiousness: understanding its impact on epidemiology and control

Variation in the ability to transmit infection is an essential aspect of tuberculosis spread across populations. However, the impact of this phenomenon on disease control is not well understood. This thesis examines the magnitude and impact of variation in patients’ capacity to infect others by analysing contact investigation data and simulating disease control mechanisms. The thesis shows that there is enormous variation between patients with tuberculosis in the number of individuals they infect. It also shows that targeting disease control methods towards patients with higher capacity to transmit the infection is considerably more effective than mass interventions.