Tuberculosis models with fast and slow dynamics: the role of close and casual contacts.

Models that incorporate local and individual interactions are introduced in the context of the transmission dynamics of tuberculosis (TB). The multi-level contact structure implicitly assumes that individuals are at risk of infection from close contacts in generalized household (clusters) as well as from casual (random) contacts in the general population. Epidemiological time scales are used to reduce the dimensionality of the model and singular perturbation methods are used to corroborate the results of time-scale approximations. The concept and impact of optimal average cluster or generalized household size on TB dynamics is discussed. We also discuss the potential impact of our results on the spread of TB.