Mathematical modeling and optimal control of tuberculosis spread among smokers with case detection

Tuberculosis (TB) remains one of deadly infectious diseases worldwide. Smoking habits are a significant factor that can increase TB transmission rates, as smokers are more susceptible to contracting TB than nonsmokers. Therefore, a control strategy that focused on minimizing TB transmission among smokers was essential. The control of TB transmission was evaluated based on the case detection rate. Undetected TB cases often resulted from economic challenges, low awareness, negative stigma toward TB patients, and health system delay (HSD). In this study, we developed a mathematical model that captured the dynamics of TB transmission specifically among smokers, incorporating the effects of case detection. Our innovative approach lied in the integration of smoking behavior as a key factor in TB transmission dynamics, which has been underexplored in previous models. We analyzed the existence and stability of the TB model equilibrium based on the basic reproduction number. Additionally, parameter sensitivity analysis was conducted to identify the most influential factors in the spread of the disease. Furthermore, this study investigated the effectiveness of various control strategies, including social distancing for smokers, TB screening in high-risk populations, and TB treatment in low-income communities. By employing the Pontryagin maximum principle, we solved optimal control problems to determine the most effective combination of interventions. Simulation results demonstrated that a targeted combination of control measures can effectively reduce the number of TB-infected individuals.