The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis
Objectives: To quantify the South African adult tuberculosis (TB) incidence and mortality attributable to HIV between 1990 and 2019 and to estimate the reduction in TB incidence due to directly observed therapy, antiretroviral therapy (ART), isoniazid preventive therapy, increased TB screening, and...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | International Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971222004386 |
| _version_ | 1828144374322561024 |
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| author | Mmamapudi Kubjane, MPH Muhammad Osman, PhD Andrew Boulle, PhD Leigh F. Johnson, PhD |
| author_facet | Mmamapudi Kubjane, MPH Muhammad Osman, PhD Andrew Boulle, PhD Leigh F. Johnson, PhD |
| author_sort | Mmamapudi Kubjane, MPH |
| collection | DOAJ |
| description | Objectives: To quantify the South African adult tuberculosis (TB) incidence and mortality attributable to HIV between 1990 and 2019 and to estimate the reduction in TB incidence due to directly observed therapy, antiretroviral therapy (ART), isoniazid preventive therapy, increased TB screening, and Xpert MTB/RIF. Methods: We developed a dynamic TB transmission model for South Africa. A Bayesian approach was used to calibrate the model to South African-specific data sources. Counterfactual scenarios were simulated to estimate TB incidence and mortality attributable to HIV and the impact of interventions on TB incidence. Results: Between 1990 and 2019, 8.8 million (95% confidence interval [CI] 8.3-9.3 million) individuals developed TB, and 2.1 million (95% CI 2.0-2.2 million) died from TB. A total of 55% and 69% of TB cases and mortality were due to HIV, respectively. Overall, TB screening and ART substantially reduced TB incidence by 28.2% (95% CI 26.4-29.8%) and 20.0% (95% CI 19.2-20.7%), respectively, in 2019; other interventions had minor impacts. Conclusion: HIV has dramatically increased TB incidence and mortality in South Africa. The provision of ART and intensification of TB screening explained most recent declines in TB incidence. |
| first_indexed | 2024-04-11T20:14:48Z |
| format | Article |
| id | doaj.art-90ef00c147304e2db9df3763cb399108 |
| institution | Directory Open Access Journal |
| issn | 1201-9712 |
| language | English |
| last_indexed | 2024-04-11T20:14:48Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj.art-90ef00c147304e2db9df3763cb3991082022-12-22T04:05:00ZengElsevierInternational Journal of Infectious Diseases1201-97122022-09-01122811819The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysisMmamapudi Kubjane, MPH0Muhammad Osman, PhD1Andrew Boulle, PhD2Leigh F. Johnson, PhD3Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South AfricaDesmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa; School of Human Sciences, Faculty of Education, Health and Human Sciences, University of Greenwich, London, United KingdomCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Western Cape Provincial Department of Health, Cape Town, South AfricaCentre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa; Correspondence to: Associate Professor Leigh F. Johnson, Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine, University of Cape Town, South Africa, Telephone: +27 21 406 6981.Objectives: To quantify the South African adult tuberculosis (TB) incidence and mortality attributable to HIV between 1990 and 2019 and to estimate the reduction in TB incidence due to directly observed therapy, antiretroviral therapy (ART), isoniazid preventive therapy, increased TB screening, and Xpert MTB/RIF. Methods: We developed a dynamic TB transmission model for South Africa. A Bayesian approach was used to calibrate the model to South African-specific data sources. Counterfactual scenarios were simulated to estimate TB incidence and mortality attributable to HIV and the impact of interventions on TB incidence. Results: Between 1990 and 2019, 8.8 million (95% confidence interval [CI] 8.3-9.3 million) individuals developed TB, and 2.1 million (95% CI 2.0-2.2 million) died from TB. A total of 55% and 69% of TB cases and mortality were due to HIV, respectively. Overall, TB screening and ART substantially reduced TB incidence by 28.2% (95% CI 26.4-29.8%) and 20.0% (95% CI 19.2-20.7%), respectively, in 2019; other interventions had minor impacts. Conclusion: HIV has dramatically increased TB incidence and mortality in South Africa. The provision of ART and intensification of TB screening explained most recent declines in TB incidence.http://www.sciencedirect.com/science/article/pii/S1201971222004386Mathematical modelingTuberculosisHuman immunodeficiency virusTuberculosis programmatic interventionsSouth Africa |
| spellingShingle | Mmamapudi Kubjane, MPH Muhammad Osman, PhD Andrew Boulle, PhD Leigh F. Johnson, PhD The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis International Journal of Infectious Diseases Mathematical modeling Tuberculosis Human immunodeficiency virus Tuberculosis programmatic interventions South Africa |
| title | The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis |
| title_full | The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis |
| title_fullStr | The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis |
| title_full_unstemmed | The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis |
| title_short | The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modeling analysis |
| title_sort | impact of hiv and tuberculosis interventions on south african adult tuberculosis trends 1990 2019 a mathematical modeling analysis |
| topic | Mathematical modeling Tuberculosis Human immunodeficiency virus Tuberculosis programmatic interventions South Africa |
| url | http://www.sciencedirect.com/science/article/pii/S1201971222004386 |
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