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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Modeling the impact of tuberculosis interventions on epidemiologic outcomes and health system costs

Authors: Olivia Oxlade, Amy Piatek, Cheri Vincent, Dick Menzies

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Tuberculosis (TB) programs must invest in a variety of TB specific activities in order to reach ambitious global targets. Uncertainty exists surrounding the potential impact of each of these activities. The objective of our study was to model different interventions and quantify their impact on epidemiologic outcomes and costs from the health system perspective.

Methods

Decision analysis was used to define the TB patient trajectory within the health system of three different countries. We considered up to seven different interventions that could affect either the natural history of TB, or patient trajectories within the health system. The expected impact of interventions were derived from published studies where possible. Epidemiologic outcomes and associated health system costs were projected for each scenario.

Results

With no specific intervention, TB related death rates are high and less than 10% of the population starts on correct treatment. Interventions that either prevent cases or affect all patients with TB disease early in their trajectory are expected to have the biggest impact, regardless of underlying epidemiologic characteristics of the setting. In settings with a private sector, improving diagnosis and appropriate treatment across all sectors is expected to have a major impact on outcomes.

Conclusion

In all settings, the greatest benefit will come from early diagnosis of all forms of TB. Once this has been achieved more specific interventions, such as those targeting HIV, drug resistance or the private sector can be integrated to increase impact.
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Metadata
Title
Modeling the impact of tuberculosis interventions on epidemiologic outcomes and health system costs
Authors
Olivia Oxlade
Amy Piatek
Cheri Vincent
Dick Menzies
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-1480-4

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