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What is Tuberculosis? Challenging the Current Paradigm of Tuberculosis Natural History using Mathematical Modelling Techniques

Total Cost €


EC-Contrib. €






Project "TBornotTB" data sheet

The following table provides information about the project.


Organization address
city: LONDON
postcode: WC1E 7HT

contact info
title: n.a.
name: n.a.
surname: n.a.
function: n.a.
email: n.a.
telephone: n.a.
fax: n.a.

 Coordinator Country United Kingdom [UK]
 Total cost 1˙499˙818 €
 EC max contribution 1˙499˙818 € (100%)
 Programme 1. H2020-EU.1.1. (EXCELLENT SCIENCE - European Research Council (ERC))
 Code Call ERC-2017-STG
 Funding Scheme ERC-STG
 Starting year 2018
 Duration (year-month-day) from 2018-03-01   to  2023-02-28


Take a look of project's partnership.

# participants  country  role  EC contrib. [€] 


 Project objective

What is Tuberculosis (TB)? How does a person go from infection to disease, and what does this mean at the population level? For a disease that has caused over two billion deaths in human history, and is the biggest cause of death from an infection today, the natural history of TB remains stubbornly elusive. In this ERC award I will challenge current paradigms by exploring the implications of new empirical insights from basic science on our understanding of TB epidemiology and its control using mathematical modelling techniques.

My hypothesis is that the prevailing paradigm of TB natural history is overly simple, and one of the key drivers of inaccuracy in projections made by mathematical models thus far. Current models of disease typically account for two distinct stages of infection and disease, with mostly one-directional progression between them. Instead, data has shown that individuals experience a range of stages of disease intensity. Moreover, over time individuals can move between stages through a dynamic interplay between immune induced repression and disease progression.

In this ERC award I will first focus on collating the best available data to parameterize a new mathematical model of TB with unprecedented flexibility to capture the required trends. I will settle on the best model structure and understand its behavior. In the second stage, I will use the model to explore critical questions in two areas of TB research that require the detail of the new paradigm: the challenge of addressing latent tuberculosis infection; and incorporating the impact of changes in socio-economic indicators on TB trends.

The consequences of such a paradigm shift to better reflect new insights from basic science and epidemiology are important. Initial modelling of intermediate disease states and the potential for progression and regression suggests that the projected impact of diagnostic strategies is substantially reduced, both in the immediate and longer-term.


year authors and title journal last update
List of publications.
2019 Gwenan M Knight, C Finn McQuaid, Peter J Dodd, Rein M G J Houben
Global burden of latent multidrug-resistant tuberculosis: trends and estimates based on mathematical modelling
published pages: 903-912, ISSN: 1473-3099, DOI: 10.1016/s1473-3099(19)30307-x
The Lancet Infectious Diseases 19/8 2019-09-09
2018 Hanif Esmail, Peter J Dodd, Rein M G J Houben
Tuberculosis transmission during the subclinical period: could unrelated cough play a part?
published pages: 244-246, ISSN: 2213-2600, DOI: 10.1016/s2213-2600(18)30105-x
The Lancet Respiratory Medicine 6/4 2019-09-09
2018 James M Trauer, Peter J Dodd, M Gabriela M Gomes, Gabriela B Gomez, Rein M G J Houben, Emma S McBryde, Yayehirad A Melsew, Nicolas A Menzies, Nimalan Arinaminpathy, Sourya Shrestha, David W Dowdy
The Importance of Heterogeneity to the Epidemiology of Tuberculosis
published pages: 159-166, ISSN: 1058-4838, DOI: 10.1093/cid/ciy938
Clinical Infectious Diseases 69/1 2019-09-09
2018 Katherine C. Horton, Richard G. White, Rein M.G.J. Houben
Systematic neglect of men as a key population in tuberculosis
published pages: 249-253, ISSN: 1472-9792, DOI: 10.1016/
Tuberculosis 113 2019-09-09
2019 Rein M G J Houben, Hanif Esmail, Jon C Emery, Louis R Joslyn, C Finn McQuaid, Nicolas A Menzies, Joaquín Sanz, Sourya Shrestha, Richard G White, Chongguang Yang, Frank Cobelens
Spotting the old foe—revisiting the case definition for TB
published pages: 199-201, ISSN: 2213-2600, DOI: 10.1016/s2213-2600(19)30038-4
The Lancet Respiratory Medicine 7/3 2019-09-09
2018 Rein M G J Houben, Marek Lalli, Katharina Kranzer, Nick A Menzies, Samuel G Schumacher, David W Dowdy
What if They Don’t Have Tuberculosis? The Consequences and Trade-offs Involved in False-positive Diagnoses of Tuberculosis
published pages: 150-6, ISSN: 1058-4838, DOI: 10.1093/cid/ciy544
Clinical Infectious Diseases 2019-09-09
2018 Daniel J Carter, Philippe Glaziou, Knut Lönnroth, Andrew Siroka, Katherine Floyd, Diana Weil, Mario Raviglione, Rein M G J Houben, Delia Boccia
The impact of social protection and poverty elimination on global tuberculosis incidence: a statistical modelling analysis of Sustainable Development Goal 1
published pages: e514-e522, ISSN: 2214-109X, DOI: 10.1016/s2214-109x(18)30195-5
The Lancet Global Health 6/5 2019-09-09
2019 Katie D Dale, James M Trauer, Peter J Dodd, Rein M G J Houben, Justin T Denholm
Estimating Long-term Tuberculosis Reactivation Rates in Australian Migrants
published pages: , ISSN: 1058-4838, DOI: 10.1093/cid/ciz569
Clinical Infectious Diseases 2019-09-09

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