How might risk perception and risk factors influence the spread of disease? To answer this question, we must first understand how risk perception influences risk-taking behaviors that result in an increased susceptibility to infection. Risk factors classified as behavioral and medical also contribute to susceptibility. This research explores the dynamics of tuberculosis disease spread in West Kenya. Behaviors associated with tuberculosis are complex and driven by a number of factors as evidenced by the current body of knowledge. A literature review on the role of tuberculosis perception, with an emphasis on perceived causes and modes of transmission, highlights this fact. To encapsulate decisions, this research explores one behavioral consequence of risk perception: avoidance. The act of accepting risk based on some utility to interact with a known infected individual can, in some cases, be identified as risk attenuation.

In other cases, an individual may have little control over whom they interact with and when. To explore how these dynamics may influence the spread of tuberculosis; an agent-based model was employed. West Kenya was chosen to test the model due to its increasing rates of newly diagnosed tuberculosis cases and the identification of several multidrug-resistant cases. HIV and tuberculosis co-infections are also of particular concern for health officials in Kenya and many other parts of the world. Avoidance as a way to reduce contact with infectious individuals did not show a favorable result in the simulated population, and additional experiments to explore the potential consequences of an increased stigmatization of the disease brought about by widespread avoidance further produced unfavorable results. Due to crowding, avoidance did little to reduce initial infections, yet a scaling effect was identified as a limitation.

More favorable results were found when other risk factors associated with tuberculosis were reduced, effectively simulating a more resilient population able to fight off initial infection and transition to the infectious active stage of the disease. Finally, an exploration of better treatment compliance and the outcomes for a shorter treatment option showed the greatest impact on the simulated population. While education campaigns may be necessary to increase the overall understanding of tuberculosis within the population, efforts to strengthen the population against initial infection and furthering the development of shorter treatment options that improve treatment compliance will have the greatest positive impact on the population.