Assessing tuberculosis control priorities in high-burden settings: a modelling approach

The Lancet Global Health
Juan F VesgaNimalan Arinaminpathy

Abstract

In the context of WHO's End TB strategy, there is a need to focus future control efforts on those interventions and innovations that would be most effective in accelerating declines in tuberculosis burden. Using a modelling approach to link the tuberculosis care cascade to transmission, we aimed to identify which improvements in the cascade would yield the greatest effect on incidence and mortality. We engaged with national tuberculosis programmes in three country settings (India, Kenya, and Moldova) as illustrative examples of settings with a large private sector (India), a high HIV burden (Kenya), and a high burden of multidrug resistance (Moldova). We collated WHO country burden estimates, routine surveillance data, and tuberculosis prevalence surveys from 2011 (for India) and 2016 (for Kenya). Linking the tuberculosis care cascade to tuberculosis transmission using a mathematical model with Bayesian melding in each setting, we examined which cascade shortfalls would have the greatest effect on incidence and mortality, and how the cascade could be used to monitor future control efforts. Modelling suggests that combined measures to strengthen the care cascade could reduce cumulative tuberculosis incidence by 38% (95% Bayesian...Continue Reading

Citations

Sep 11, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Qi JiangQian Gao
Jan 10, 2021·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·Lu ZhangWen-Hong Zhang
Sep 21, 2019·The Lancet Global Health·Christian WejseJames M Trauer
Nov 17, 2020·American Journal of Respiratory and Critical Care Medicine·Emily A KendallDavid W Dowdy
Nov 30, 2020·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Gabriela B GomezAnna Vassall
Jan 20, 2021·Nature Communications·Han FuNimalan Arinaminpathy
Jan 8, 2021·Health Sociology Review : the Journal of the Health Section of the Australian Sociological Association·Tim Rhodes, Kari Lancaster
Mar 27, 2021·The Lancet Infectious Diseases·Pranay SinhaNatasha S Hochberg
Mar 28, 2021·Value in Health Regional Issues·Jillian L KadotaPriya B Shete

Related Concepts

Patient Care
National Research Council
Obstetrics Department
Private Sector
Tuberculosis
Ultrasonography
World Health Organization
Health Care
Disease Transmission
Monitoring - Action

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