High coverage with HAART is required to substantially reduce the number of deaths from tuberculosis: system dynamics simulation.


Atun, RA; Lebcir, RM; Drobniewski, F; McKee, M; Coker, RJ; (2007) High coverage with HAART is required to substantially reduce the number of deaths from tuberculosis: system dynamics simulation. International journal of STD & AIDS, 18 (4). pp. 267-73. ISSN 0956-4624 DOI: https://doi.org/10.1258/095646207780659024

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Abstract

We used a system dynamics simulation model of the transmission dynamics of drug-sensitive tuberculosis (DSTB), multidrug-resistant tuberculosis (MDRTB) and HIV to estimate the impact of coverage with highly active antiretroviral therapy (HAART) and different cure rates for MDRTB in settings of explosive HIV epidemics and high MDRTB levels. Population coverage levels at 0%, 25%, 50%, 75% and 100% for HAART, and 5% and 80% of MDRTB treatment cure rates were simulated over a 10-year period and cumulative deaths from tuberculosis and HIV-associated tuberculosis were estimated for populations with latent tuberculosis, DSTB, MDRTB, HIV and HIV-associated tuberculosis. Depending on levels of HAART population coverage, increasing MDRTB cure rates from 5% to 80% reduces cumulative tuberculosis deaths by 1% and 13%. High population coverage with HAART (75% or higher), allied with high MDRTB cure rates, reduces cumulative deaths by 60%, with limited impact below this level. High coverage with HAART is required to substantially reduce the number of deaths from tuberculosis.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Faculty of Public Health and Policy > Dept of Global Health and Development
Research Centre: ECOHOST - The Centre for Health and Social Change
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 17509178
Web of Science ID: 246209500011
URI: http://researchonline.lshtm.ac.uk/id/eprint/9922

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