Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries
Background: We aimed to estimate the disease burden of Tuberculosis (TB) and return on investment of TB care in selected high-burden countries of the Western Pacific Region (WPR) until 2030. Methods: We projected the TB epidemic in Viet Nam and Lao People's Democratic Republic (PDR) 2020–2030 u...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606521000560 |
| _version_ | 1818920092497346560 |
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| author | Janne Estill Tauhid Islam Rein M.G.J. Houben Jamie Rudman Romain Ragonnet Emma S. McBryde James M. Trauer Erol Orel Anh Tuan Nguyen Kalpeshsinh Rahevar Fukushi Morishita Kyung Hyun Oh Mario C. Raviglione Olivia Keiser |
| author_facet | Janne Estill Tauhid Islam Rein M.G.J. Houben Jamie Rudman Romain Ragonnet Emma S. McBryde James M. Trauer Erol Orel Anh Tuan Nguyen Kalpeshsinh Rahevar Fukushi Morishita Kyung Hyun Oh Mario C. Raviglione Olivia Keiser |
| author_sort | Janne Estill |
| collection | DOAJ |
| description | Background: We aimed to estimate the disease burden of Tuberculosis (TB) and return on investment of TB care in selected high-burden countries of the Western Pacific Region (WPR) until 2030. Methods: We projected the TB epidemic in Viet Nam and Lao People's Democratic Republic (PDR) 2020–2030 using a mathematical model under various scenarios: counterfactual (no TB care); baseline (TB care continues at current levels); and 12 different diagnosis and treatment interventions. We retrieved previous modeling results for China and the Philippines. We pooled the new and existing information on incidence and deaths in the four countries, covering >80% of the TB burden in WPR. We estimated the return on investment of TB care and interventions in Viet Nam and Lao PDR using a Solow model. Findings: In the baseline scenario, TB incidence in the four countries decreased from 97•0/100,000/year (2019) to 90•1/100,000/year (2030), and TB deaths from 83,300/year (2019) to 71,100/year (2030). Active case finding (ACF) strategies (screening people not seeking care for respiratory symptoms) were the most effective single interventions. Return on investment (2020–2030) for TB care in Viet Nam and Lao PDR ranged US$4-US$49/dollar spent; additional interventions brought up to US$2•7/dollar spent. Interpretation: In the modeled countries, TB incidence will only modestly decrease without additional interventions. Interventions that include ACF can reduce TB burden but achieving the End TB incidence and mortality targets will be difficult without new transformational tools (e.g. vaccine, new diagnostic tools, shorter treatment). However, TB care, even at its current level, can bring a multiple-fold return on investment. Funding: World Health Organization Western Pacific Regional Office; Swiss National Science Foundation Grant 163878. |
| first_indexed | 2024-12-20T01:16:15Z |
| format | Article |
| id | doaj.art-c595c4fdbcc7466fae2a1b1e2c5d9255 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-12-20T01:16:15Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-c595c4fdbcc7466fae2a1b1e2c5d92552022-12-21T19:58:34ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652021-06-0111100147Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countriesJanne Estill0Tauhid Islam1Rein M.G.J. Houben2Jamie Rudman3Romain Ragonnet4Emma S. McBryde5James M. Trauer6Erol Orel7Anh Tuan Nguyen8Kalpeshsinh Rahevar9Fukushi Morishita10Kyung Hyun Oh11Mario C. Raviglione12Olivia Keiser13Institute of Global Health, University of Geneva, Geneva, Switzerland; Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland; Corresponding author at: Institute of Global Health, University of Geneva, 9 Chemin des Mines, 1202 Geneva, Switzerland.End TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, PhilippinesTB Modeling Group, Department of Infectious Disease Epidemiology, London School of Hygiene ad Tropical Medicine, London, United KingdomTB Modeling Group, Department of Infectious Disease Epidemiology, London School of Hygiene ad Tropical Medicine, London, United KingdomSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaAustralian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaInstitute of Global Health, University of Geneva, Geneva, SwitzerlandDepartment of TB and Lung Diseases, Hanoi Medical University, Hanoi, Viet NamEnd TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, PhilippinesEnd TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, PhilippinesEnd TB and Leprosy Unit, Division of Programmes for Disease Control, WHO Regional Office for the Western Pacific, Manila, PhilippinesCentre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, ItalyInstitute of Global Health, University of Geneva, Geneva, SwitzerlandBackground: We aimed to estimate the disease burden of Tuberculosis (TB) and return on investment of TB care in selected high-burden countries of the Western Pacific Region (WPR) until 2030. Methods: We projected the TB epidemic in Viet Nam and Lao People's Democratic Republic (PDR) 2020–2030 using a mathematical model under various scenarios: counterfactual (no TB care); baseline (TB care continues at current levels); and 12 different diagnosis and treatment interventions. We retrieved previous modeling results for China and the Philippines. We pooled the new and existing information on incidence and deaths in the four countries, covering >80% of the TB burden in WPR. We estimated the return on investment of TB care and interventions in Viet Nam and Lao PDR using a Solow model. Findings: In the baseline scenario, TB incidence in the four countries decreased from 97•0/100,000/year (2019) to 90•1/100,000/year (2030), and TB deaths from 83,300/year (2019) to 71,100/year (2030). Active case finding (ACF) strategies (screening people not seeking care for respiratory symptoms) were the most effective single interventions. Return on investment (2020–2030) for TB care in Viet Nam and Lao PDR ranged US$4-US$49/dollar spent; additional interventions brought up to US$2•7/dollar spent. Interpretation: In the modeled countries, TB incidence will only modestly decrease without additional interventions. Interventions that include ACF can reduce TB burden but achieving the End TB incidence and mortality targets will be difficult without new transformational tools (e.g. vaccine, new diagnostic tools, shorter treatment). However, TB care, even at its current level, can bring a multiple-fold return on investment. Funding: World Health Organization Western Pacific Regional Office; Swiss National Science Foundation Grant 163878.http://www.sciencedirect.com/science/article/pii/S2666606521000560TuberculosisMathematical modelHealth economicsReturn on investmentWestern Pacific Region |
| spellingShingle | Janne Estill Tauhid Islam Rein M.G.J. Houben Jamie Rudman Romain Ragonnet Emma S. McBryde James M. Trauer Erol Orel Anh Tuan Nguyen Kalpeshsinh Rahevar Fukushi Morishita Kyung Hyun Oh Mario C. Raviglione Olivia Keiser Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries The Lancet Regional Health. Western Pacific Tuberculosis Mathematical model Health economics Return on investment Western Pacific Region |
| title | Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries |
| title_full | Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries |
| title_fullStr | Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries |
| title_full_unstemmed | Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries |
| title_short | Tuberculosis in the Western Pacific Region: Estimating the burden of disease and return on investment 2020–2030 in four countries |
| title_sort | tuberculosis in the western pacific region estimating the burden of disease and return on investment 2020 2030 in four countries |
| topic | Tuberculosis Mathematical model Health economics Return on investment Western Pacific Region |
| url | http://www.sciencedirect.com/science/article/pii/S2666606521000560 |
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