Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models

Houben, Rein M. G. J.; Menzies, Nicolas A; Sumner, Tom; Huynh, Grace; Arinaminpathy, Nimalan; Goldhaber-Fiebert, Jeremy D.; Lin, Hsien Ho; Wu, Chieh Yin; Mandal, Sandip; Pandey, Surabhi; Suen, Sze chuan; Bendavid, Eran; Azman, Andrew S.; Dowdy, David W.; Bacaër, Nicolas; Rhines, Allison S.; Feldman, Marcus W.; Handel, Andreas; Whalen, Christopher C.; Chang, Stewart T.; Wagner, Bradley G.; Eckhoff, Philip A.; Trauer, James M.; Denholm, Justin T.; McBryde, Emma S.; Cohen, Ted; Salomon, Joshua A.; Pretorius, Carel; Lalli, Marek; Eaton, Jeffrey W.; Boccia, Delia; Hosseini, Mohammad; Gomez, Gabriela B.; Sahu, Suvanand; Daniels, Colleen; Diţiu, Lucica; Chin, Daniel P.; Wang, Lixia; Chadha, V. K.; Rade, Kiran; Dewan, Puneet; Hippner, Piotr; Charalambous, Salome; Grant, Alison D.; Churchyard, Gavin J.; Pillay, Yogan; Mametja, L D; Kimerling, Michael E.; Vassall, Anna; White, Richard G.

doi:10.1016/s2214-109x(16)30199-1

Cited by 156 publications

(165 citation statements)

References 29 publications

Supporting

Mentioning

164

Contrasting

Unclassified

Order By: Relevance

“…13,14 Despite more than a century of epidemiological research into tuberculosis, concrete evidence for these underlying processes is imperfect, 15 and studies have taken various approaches for constructing and parameterising transmission models. This variation can be consequential: in a modelling collaboration examining the post-2015 End TB Strategy, 16 variation in epidemiological assumptions was identified as a cause of the wide range of estimates produced for the health impact 17 and cost-effectiveness 18 of expanded tuberculosis control. Several reviews 13,14,19 have described standard tuberculosis modelling approaches, and methodological studies 20–25 have examined specific modelling approaches.…”

Section: Introductionmentioning

confidence: 99%

Progression from latent infection to active disease in dynamic tuberculosis transmission models: a systematic review of the validity of modelling assumptions

Menzies

Wolf

Connors

et al. 2018

The Lancet Infectious Diseases

Self Cite

101

View full text Add to dashboard Cite

Mathematical modelling is commonly used to evaluate infectious disease control policy and is influential in shaping policy and budgets. Mathematical models necessarily make assumptions about disease natural history and, if these assumptions are not valid, the results of these studies can be biased. We did a systematic review of published tuberculosis transmission models to assess the validity of assumptions about progression to active disease after initial infection (PROSPERO ID CRD42016030009). We searched PubMed, Web of Science, Embase, Biosis, and Cochrane Library, and included studies from the earliest available date (Jan 1, 1962) to Aug 31, 2017. We identified 312 studies that met inclusion criteria. Predicted tuberculosis incidence varied widely across studies for each risk factor investigated. For population groups with no individual risk factors, annual incidence varied by several orders of magnitude, and 20-year cumulative incidence ranged from close to 0% to 100%. A substantial proportion of modelled results were inconsistent with empirical evidence: for 10-year cumulative incidence, 40% of modelled results were more than double or less than half the empirical estimates. These results demonstrate substantial disagreement between modelling studies on a central feature of tuberculosis natural history. Greater attention to reproducing known features of epidemiology would strengthen future tuberculosis modelling studies, and readers of modelling studies are recommended to assess how well those studies demonstrate their validity.

show abstract

Section: Introductionmentioning

confidence: 99%

Progression from latent infection to active disease in dynamic tuberculosis transmission models: a systematic review of the validity of modelling assumptions

Menzies

Wolf

Connors

et al. 2018

The Lancet Infectious Diseases

Self Cite

101

View full text Add to dashboard Cite

show abstract

“…Of 11 models that participated in the modelling exercise, 9 fulfilled these requirements and contributed inputs for the economic analysis. Key features of participating models, calibration targets, and modelled outcomes are described in Tables S1–3, and additional details are provided in Houben et al 2 .…”

Section: Methodsmentioning

confidence: 99%

“…Previously, the TB Modelling and Analysis Consortium (TB-MAC) performed a multi-model evaluation to assess the goals’ feasibility, finding that aggressive but feasible scale-up of existing approaches could achieve the reductions described by the global targets in South Africa but not in India or China. 2 …”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models

Menzies

Gomez

Bozzani

et al. 2016

The Lancet Global Health

Self Cite

View full text Add to dashboard Cite

BACKGROUND The End TB Strategy sets global goals of reducing TB incidence and mortality by 50% and 75% respectively by 2025. We assessed resource requirements and cost-effectiveness of strategies to achieve these targets in China, India, and South Africa. METHODS We examined intervention scenarios developed in consultation with country stakeholders, which scaled-up existing interventions to high but feasible coverage by 2025. Nine independent TB modelling groups collaborated to estimate policy outcomes, and we costed each scenario by synthesizing service utilization estimates, empirical cost data, and expert opinion on implementation strategies. We estimated health impact and resource implications for 2016–2035, including patient-incurred costs. To assess resource requirements and cost-effectiveness, we compared scenarios to a base case representing continued current practice. FINDINGS Incremental TB service costs differed by scenario and country, and in some cases more than doubled current funding needs. In general, expanding TB services substantially reduced patient-incurred costs; and in India and China this produced net cost-savings for most interventions under a societal perspective. In all countries, expanding TB care access produced substantial health gains. Compared to current practice, most intervention approaches appeared highly cost-effective when compared to conventional cost-effectiveness thresholds. INTERPRETATION Expanding TB services appears cost-effective for high-burden countries and could generate substantial health and economic benefits for patients, though funding needs challenge affordability. Further work is required to determine the optimal intervention mix for each country.

show abstract

“…However, very few candidate assays are in the R&D pipeline for true point-of-care tests in RDT format, with disappointing results from biomarker research [103]. There are molecular platforms in the pipeline that will get us closer to patients, but it remains unclear whether test implementation would be cost-effective [104, 105]. Xpert Omni (Cepheid, CA, USA) may address the criticism of GeneXpert, which requires a laboratory infrastructure (e.g.…”

Section: Futurementioning

confidence: 99%

Diagnosis of opportunistic infections

Scott

Silva

Boehme

et al. 2017

Current Opinion in HIV and AIDS

View full text Add to dashboard Cite

Purpose of the review TB incidence has declined ~1.5% annually since 2000, but continued to affect 10.4 million individuals in 2015, with 1/3 remaining undiagnosed or under reported. The diagnosis of TB among those co-infected with HIV is challenging as TB remains the leading cause of death in such individuals. Accurate and rapid diagnosis of active TB will avert mortality in both adults and children, reduce transmission, and assist in timeous decisions for ART initiation. This review describes advances in diagnosing TB, especially among HIV co-infected individuals, highlights national program’s uptake, and impact on patient care. Recent Findings The TB diagnostic landscape has been transformed over the last 5 years. Molecular diagnostics such as Xpert MTB/RIF, which simultaneously detects M. tuberculosis resistance to rifampicin, has revolutionised TB control programs. WHO endorsed the use of Xpert MTB/RIF in 2010 for use in HIV/TB co-infected patients, and later in 2013 for use as the initial diagnostic test for all adults and children with signs and symptoms of pulmonary TB. Line probe assays (LPAs) are recommended for the detection of rifampicin and isoniazid resistance in sputum smear-positive specimens and mycobacterial cultures. A second-line line probe assay has been recommended for the diagnosis of extensively drug-resistant (XDR)-TB Assays such as the urine lateral flow(LF)-lipoarabinomannan(LAM), can be used at the point of care (POC) and have a niche role to supplement the diagnosis of TB in seriously ill HIV infected, hospitalized patients with low CD4<100cells/μl. Polyvalent platforms such as the m2000 (Abbott Molecular, IL, USA) and GeneXpert (Cepheid, CA, USA) offer potential for integration of HIV and TB testing services. While the Research and Development (R&D) pipeline appears to be rich at first glance, there are actually few leads for true POC tests that would allow for earlier TB diagnosis or rapid, comprehensive drug susceptibility testing, especially when considering the very high attrition rates observed between biomarker discovery and product market entry. Summary In this review, we describe diagnostic strategies specifically for HIV and TB co-infected individuals. Molecular diagnostics in particular within the past 5 years have revolutionized and “disrupted” this field. They lend themselves to integration of services with platforms capable of polyvalent testing. Impact on patient care is, however, still debatable. What has been highlighted is the need for health system strengthening and for true POC testing that can be used in active case finding.

show abstract

Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models

Abstract: Bill and Melinda Gates Foundation.

Cited by 156 publications

References 29 publications

Progression from latent infection to active disease in dynamic tuberculosis transmission models: a systematic review of the validity of modelling assumptions

Progression from latent infection to active disease in dynamic tuberculosis transmission models: a systematic review of the validity of modelling assumptions

Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models

Diagnosis of opportunistic infections

Contact Info

Product

Resources

About