Dynamics and optimal control of tuberculosis in the presence of type 2 diabetes
Moch. Fandi Ansori, Handika Lintang Saputra, Mehmet Gumus, Shewafera Wondimagegnhu Teklu
article (Uluslararası, Hakemli) | Yazar(lar): Moch. Fandi Ansori, Handika Lintang Saputra, Mehmet Gumus, Shewafera Wondimagegnhu Teklu | Yıl: 2026 | Dergi/Kurum: SCIENTIFIC AFRICAN | İndeks: WOS.ESCI | DOI: 10.1016/j.sciaf.2026.e03588 | Anahtar Kelimeler: Mathematical model, Diabetes progression, Intervention strategy,
In this paper, we develop an integrated modeling framework for tuberculosis (TB) and type 2 diabetes (T2D) comorbidity. We combine an SVEIR TB model with a population-level progression model of type 2 diabetes to capture the full comorbidity feedback loop, which has rarely been addressed in the literature. Our analysis proceeds step by step: we first prove that the model is biologically well-behaved (non-negative and bounded solutions), then derive the reproduction numbers for the TB-only and coupled systems. For the TB-only subsystem we establish local and global stability of the disease-free equilibrium and show that the system undergoes a forward bifurcation. The T2D-only subsystem yields an explicit general solution which is uncommon in population-level models. Numerical simulations then reveal three practical insights. First, a forward bifurcation also governs the full TB-T2D system. Second, a global sensitivity analysis identifies the TB transmission rates as the main drivers of the epidemic, while vaccination and recovery act as powerful brakes. Third, when we optimize four interventions (vaccination boost, lifestyle change, diabetes treatment, and TB exposure reduction) using a cost-effectiveness ratio, one strategy stands out: directly reducing TB exposure (e.g., masks, ventilation) to be the most cost-effective under the assumed parameters. Lifestyle and diabetes treatments alone do little to curb TB; they only become worthwhile when paired with exposure reduction.