Citation

BibTex format

@article{Mangal:2024:10.1016/S2214-109X(24)00259-6,
author = {Mangal, TD and Mohan, S and Colbourn, T and Collins, JH and Graham, M and Jahn, A and Janouková, E and Lin, IL and Smith, RM and Mnjowe, E and Molaro, M and Mwenyenkulu, TE and Nkhoma, D and She, B and Tamuri, A and Revill, P and Phillips, AN and Mfutso-Bengo, J and Hallett, TB},
doi = {10.1016/S2214-109X(24)00259-6},
journal = {The Lancet Global Health},
pages = {e1638--e1648},
title = {Assessing the effect of health system resources on HIV and tuberculosis programmes in Malawi: a modelling study},
url = {http://dx.doi.org/10.1016/S2214-109X(24)00259-6},
volume = {12},
year = {2024}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - BACKGROUND: Malawi is progressing towards UNAIDS and WHO End TB Strategy targets to eliminate HIV/AIDS and tuberculosis. We aimed to assess the prospective effect of achieving these goals on the health and health system of the country and the influence of consumable constraints. METHODS: In this modelling study, we used the Thanzi la Onse (Health for All) model, which is an individual-based multi-disease simulation model that simulates HIV and tuberculosis transmission, alongside other diseases (eg, malaria, non-communicable diseases, and maternal diseases), and gates access to essential medicines according to empirical estimates of availability. The model integrates dynamic disease modelling with health system engagement behaviour, health system use, and capabilities (ie, personnel and consumables). We used 2018 data on the availability of HIV and tuberculosis consumables (for testing, treatment, and prevention) across all facility levels of the country to model three scenarios of HIV and tuberculosis programme scale-up from Jan 1, 2023, to Dec 31, 2033: a baseline scenario, when coverage remains static using existing consumable constraints; a constrained scenario, in which prioritised interventions are scaled up with fixed consumable constraints; and an unconstrained scenario, in which prioritised interventions are scaled up with maximum availability of all consumables related to HIV and tuberculosis care. FINDINGS: With uninterrupted medical supplies, in Malawi, we projected HIV and tuberculosis incidence to decrease to 26 (95% uncertainty interval [UI] 19-35) cases and 55 (23-74) cases per 100000 person-years by 2033 (from 152 [98-195] cases and 123 [99-160] cases per 100000 person-years in 2023), respectively, with programme scale-up, averting a total of 12·21 million (95% UI 11·39-14·16) disability-adjusted life-years. However, the effect was compromised by restricted access to key medicines, resulting in approximately 58700 additional
AU - Mangal,TD
AU - Mohan,S
AU - Colbourn,T
AU - Collins,JH
AU - Graham,M
AU - Jahn,A
AU - Janouková,E
AU - Lin,IL
AU - Smith,RM
AU - Mnjowe,E
AU - Molaro,M
AU - Mwenyenkulu,TE
AU - Nkhoma,D
AU - She,B
AU - Tamuri,A
AU - Revill,P
AU - Phillips,AN
AU - Mfutso-Bengo,J
AU - Hallett,TB
DO - 10.1016/S2214-109X(24)00259-6
EP - 1648
PY - 2024///
SN - 2214-109X
SP - 1638
TI - Assessing the effect of health system resources on HIV and tuberculosis programmes in Malawi: a modelling study
T2 - The Lancet Global Health
UR - http://dx.doi.org/10.1016/S2214-109X(24)00259-6
UR - https://www.ncbi.nlm.nih.gov/pubmed/39304236
UR - https://www.sciencedirect.com/science/article/pii/S2214109X24002596?via%3Dihub
UR - http://hdl.handle.net/10044/1/112579
VL - 12
ER -

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