Multivariate Markovian modeling of tuberculosis: Forecast for the United States

We have developed a computer-implemented, multivariate Markov chain model t o project tuberculosis (TB) incidence in the United States from 1980 to 201 0 in disaggregated demographic groups. Uncertainty in model parameters and in the projections is represented by fuzzy numbers. Projections are made un der the assumption that current TB control measures will remain unchanged f or the projection period. The projections of the model demonstrate an inter mediate increase in national TB incidence (similar to that which actually o ccurred) followed by continuing decline. The rate of decline depends strong ly on geographic, racial, and ethnic characteristics. The model predicts th at the rate of decline in the number of cases among Hispanics will be slowe r than among white non-Hispanics and black non-Hispanics-a prediction suppo rted by the most recent data.