Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions
Introduction: Diabetes mellitus (DM) is a leading driver of tuberculosis (TB) disease in TB-DM burdened countries. We aimed to assess the impact on TB disease of several intervention strategies targeting people with DM in India. Methods: A previously validated TB-DM mathematical model was extended t...
| Үндсэн зохиолчид: | , , |
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| Формат: | Өгүүллэг |
| Хэл сонгох: | English |
| Хэвлэсэн: |
Elsevier
2020-03-01
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| Цуврал: | Epidemics |
| Онлайн хандалт: | http://www.sciencedirect.com/science/article/pii/S1755436519300672 |
| _version_ | 1828944692810612736 |
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| author | Susanne F. Awad Julia A. Critchley Laith J. Abu-Raddad |
| author_facet | Susanne F. Awad Julia A. Critchley Laith J. Abu-Raddad |
| author_sort | Susanne F. Awad |
| collection | DOAJ |
| description | Introduction: Diabetes mellitus (DM) is a leading driver of tuberculosis (TB) disease in TB-DM burdened countries. We aimed to assess the impact on TB disease of several intervention strategies targeting people with DM in India. Methods: A previously validated TB-DM mathematical model was extended to include interventions targeting DM individuals. The model stratified the population by age, DM status, TB infection status and stage, TB disease form, treatment, recovery, and intervention status. Results: By 2050, different TB vaccination strategies (coverage of 50 % and vaccine efficacies ranging between 50 %–60 %) reduced TB incidence and mortality rates by 4.5 %–20.8 % and 4.1 %–22.1 %, respectively, and averted 3.1 %–12.8 % of TB disease cases in the total population. Number of vaccinations needed to avert one TB case (effectiveness) was 14–105. Varying the coverage levels of latent TB treatment (coverage of 50 %–80 % and drug effectiveness of 90 %) reduced TB incidence and mortality rates by 7.1 %–11.3 % and 8.2 %–13.0 %, respectively, averting 4.2 %–6.7 % of TB cases, with effectiveness of 38–40. Different scenarios for dual and concurrent treatment of those with TB and DM, reduced TB incidence and mortality rates by 0.1 %–0.4 % and 1.3 %–4.8 %, respectively, averting 0.1 %–0.2 % of TB cases, with effectiveness of 28–107. Different scenarios for managing and controlling DM (regardless of TB status) reduced TB incidence and mortality rates by 4.5 %–16.5 % and 6.5 %–22.2 %, respectively, averting 2.9 %–10.8 % of TB cases, with effectiveness of 6–24. Conclusion: Gains can be attained by targeting DM individuals with interventions to reduce TB burden. Most strategies were effective with <50 intervention doses needed to avert one TB disease case, informing key updates of current treatment guidelines. Keywords: Tuberculosis, Diabetes mellitus, Interventions, Vaccine, Latent tuberculosis infection, Diabetes mellitus management, Mathematical modelling |
| first_indexed | 2024-12-14T04:39:09Z |
| format | Article |
| id | doaj.art-01acc105a31c4b3a8d35e39e8b68d78e |
| institution | Directory Open Access Journal |
| issn | 1755-4365 |
| language | English |
| last_indexed | 2024-12-14T04:39:09Z |
| publishDate | 2020-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epidemics |
| spelling | doaj.art-01acc105a31c4b3a8d35e39e8b68d78e2022-12-21T23:16:51ZengElsevierEpidemics1755-43652020-03-0130Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictionsSusanne F. Awad0Julia A. Critchley1Laith J. Abu-Raddad2Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar; Population Health Research Institute, St George’s, University of London, London, UK; Corresponding author at: Infectious Disease Epidemiology Group, Weill Cornell Medicine – Qatar, Qatar Foundation – Education City, P.O. Box 24144, Doha, Qatar.Population Health Research Institute, St George’s, University of London, London, UKInfectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar; Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, NY, USA; College of Health and Life Sciences, Hamad bin Khalifa University, Doha, QatarIntroduction: Diabetes mellitus (DM) is a leading driver of tuberculosis (TB) disease in TB-DM burdened countries. We aimed to assess the impact on TB disease of several intervention strategies targeting people with DM in India. Methods: A previously validated TB-DM mathematical model was extended to include interventions targeting DM individuals. The model stratified the population by age, DM status, TB infection status and stage, TB disease form, treatment, recovery, and intervention status. Results: By 2050, different TB vaccination strategies (coverage of 50 % and vaccine efficacies ranging between 50 %–60 %) reduced TB incidence and mortality rates by 4.5 %–20.8 % and 4.1 %–22.1 %, respectively, and averted 3.1 %–12.8 % of TB disease cases in the total population. Number of vaccinations needed to avert one TB case (effectiveness) was 14–105. Varying the coverage levels of latent TB treatment (coverage of 50 %–80 % and drug effectiveness of 90 %) reduced TB incidence and mortality rates by 7.1 %–11.3 % and 8.2 %–13.0 %, respectively, averting 4.2 %–6.7 % of TB cases, with effectiveness of 38–40. Different scenarios for dual and concurrent treatment of those with TB and DM, reduced TB incidence and mortality rates by 0.1 %–0.4 % and 1.3 %–4.8 %, respectively, averting 0.1 %–0.2 % of TB cases, with effectiveness of 28–107. Different scenarios for managing and controlling DM (regardless of TB status) reduced TB incidence and mortality rates by 4.5 %–16.5 % and 6.5 %–22.2 %, respectively, averting 2.9 %–10.8 % of TB cases, with effectiveness of 6–24. Conclusion: Gains can be attained by targeting DM individuals with interventions to reduce TB burden. Most strategies were effective with <50 intervention doses needed to avert one TB disease case, informing key updates of current treatment guidelines. Keywords: Tuberculosis, Diabetes mellitus, Interventions, Vaccine, Latent tuberculosis infection, Diabetes mellitus management, Mathematical modellinghttp://www.sciencedirect.com/science/article/pii/S1755436519300672 |
| spellingShingle | Susanne F. Awad Julia A. Critchley Laith J. Abu-Raddad Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions Epidemics |
| title | Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions |
| title_full | Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions |
| title_fullStr | Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions |
| title_full_unstemmed | Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions |
| title_short | Epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in India: Modelling based predictions |
| title_sort | epidemiological impact of targeted interventions for people with diabetes mellitus on tuberculosis transmission in india modelling based predictions |
| url | http://www.sciencedirect.com/science/article/pii/S1755436519300672 |
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