Imperial College London

Professor Nimalan Arinaminpathy (Nim Pathy)

Faculty of MedicineSchool of Public Health

Professor in Mathematical Epidemiology
 
 
 
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Contact

 

nim.pathy Website

 
 
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Location

 

Praed StreetSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

115 results found

Ricks S, Singh A, Sodhi R, Pal A, Arinaminpathy Net al., 2024, Operational priorities for engaging with India’s private healthcare sector for the control of tuberculosis: a modelling study, BMJ Open, ISSN: 2044-6055

Objectives: To estimate the potential impact of expanding services offered by the Joint Effort for Elimination of Tuberculosis (“JEET”), the largest private sector engagement initiative for tuberculosis (TB) in India. Design: We developed a mathematical model of TB transmission dynamics, coupled with a cost model. Setting: Ahmedabad and New Delhi, two cities with contrasting levels of JEET coverage. Participants: Estimated patients with TB in Ahmedabad and New Delhi. Interventions: We investigated the epidemiological impact of expanding three different PPSA services: provider recruitment, uptake of CB-NAAT (cartridge-based nucleic acid amplification tests) and uptake of adherence support mechanisms (specifically government supplied fixed-dose combination drugs), all compared to a continuation of current TB services.Results: Our results suggest that in Delhi, increasing the use of adherence support mechanisms amongst private providers should be prioritised, having the lowest incremental cost-per-case-averted between 2020 and 2035 of $170,000 (110,000 – 310,000). Likewise in Ahmedabad, increasing provider recruitment should be prioritised, having the lowest incremental cost-per-case averted of $18,000 (12,000-29,000). Conclusion: Results illustrate how intervention priorities may vary in different settings across India, depending on local conditions, and the existing degree of uptake of PPSA services. Modelling can be a useful tool for identifying these priorities for any given setting.

Journal article

Dodd PJ, Mcquaid CF, Rao P, Abubakar I, Arinaminpathy N, Carnegie A, Cobelens F, Dowdy D, Fiekert K, Grant AD, Wu J, Nfii FN, Shaikh N, Houben RMGJ, White RGet al., 2023, Improving the quality of the Global Burden of Disease tuberculosis estimates from the Institute for Health Metrics and Evaluation, International Journal of Epidemiology, Vol: 52, Pages: 1681-1686, ISSN: 0300-5771

Journal article

Derelle R, Lees J, Phelan J, Lalvani A, Arinaminpathy N, Chindelevitch Let al., 2023, fastlin: an ultra-fast program for Mycobacterium tuberculosis complex lineage typing, Bioinformatics, Vol: 39, ISSN: 1367-4803

SUMMARY: Fastlin is a bioinformatics tool designed for rapid Mycobacterium tuberculosis complex (MTBC) lineage typing. It utilizes an ultra-fast alignment-free approach to detect previously identified barcode single nucleotide polymorphisms associated with specific MTBC lineages. In a comprehensive benchmarking against existing tools, fastlin demonstrated high accuracy and significantly faster running times. AVAILABILITY AND IMPLEMENTATION: fastlin is freely available at https://github.com/rderelle/fastlin and can easily be installed using Conda.

Journal article

Bhatia V, Rijal S, Sharma M, Islam A, Vassall A, Bhargava A, Thida A, Basri C, Onozaki I, Pai M, Rezwan MK, Arinaminpathy N, Chandrashekhar P, Sarin R, Mandal S, Raviglione Met al., 2023, Ending TB in South-East Asia: flagship priority and response transformation, Lancet Regional Health - Southeast Asia, Vol: 18, ISSN: 2772-3682

Over the decades, the global tuberculosis (TB) response has evolved from sanatoria-based treatment to DOTS (Directly Observed Therapy Shortcourse) strategy and the more recent End TB Strategy. The WHO South-East Asia Region, which accounted for 45% of new TB patients and 50% of deaths globally in 2021, is pivotal to the global fight against TB. "Accelerate Efforts to End TB" by 2030 was adopted as a South-East Asia Regional Flagship Priority (RFP) in 2017. This article illustrates intensified and transformed approaches to address the disease burden following the adoption of RFP and new challenges that emerged during the COVID-19 pandemic. TB case notifications improved by 25% and treatment success rates improved by 6% between 2016 and 2019 due to interventions ranging from galvanising political commitments to empowering and engaging communities. Cumulative TB programme budget allocations in 2022 reached US$ 1.4 billion, about two and a half times the budget in 2016. An ambitious Regional Strategic Plan towards ending TB, 2021-2025, identifies priority interventions that will need investments of up to US$ 3 billion a year to fully implement them. Moving forward, countries in the Region need to leverage RFP and take up intensified, people-centred, holistic interventions for prevention, diagnosis, treatment and care of TB with commensurate investments and cross-ministerial and multi-sectoral coordination.

Journal article

Reid M, Agbassi YJP, Arinaminpathy N, Bercasio A, Bhargava A, Bhargava M, Bloom A, Cattamanchi A, Chaisson R, Chin D, Churchyard G, Cox H, Denkinger CM, Ditiu L, Dowdy D, Dybul M, Fauci A, Fedaku E, Gidado M, Harrington M, Hauser J, Heitkamp P, Herbert N, Herna Sari A, Hopewell P, Kendall E, Khan A, Kim A, Koek I, Kondratyuk S, Krishnan N, Ku C-C, Lessem E, McConnell EV, Nahid P, Oliver M, Pai M, Raviglione M, Ryckman T, Schäferhoff M, Silva S, Small P, Stallworthy G, Temesgen Z, van Weezenbeek K, Vassall A, Velásquez GE, Venkatesan N, Yamey G, Zimmerman A, Jamison D, Swaminathan S, Goosby Eet al., 2023, Scientific advances and the end of tuberculosis: a report from the Lancet Commission on Tuberculosis., Lancet, Vol: 402, Pages: 1473-1498

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V Prasad P, Steele MK, Reed C, Meyers LA, Du Z, Pasco R, Alfaro-Murillo JA, Lewis B, Venkatramanan S, Schlitt J, Chen J, Orr M, Wilson ML, Eubank S, Wang L, Chinazzi M, Piontti APY, Davis JT, Halloran ME, Longini I, Vespignani A, Pei S, Galanti M, Kandula S, Shaman J, Haw DJ, Arinaminpathy N, Biggerstaff Met al., 2023, Multimodeling approach to evaluating the efficacy of layering pharmaceutical and nonpharmaceutical interventions for influenza pandemics, PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, Vol: 120, ISSN: 0027-8424

Journal article

Haw DJJ, Biggerstaff M, Prasad P, Walker J, Grenfell B, Arinaminpathy Net al., 2023, Using real-time data to guide decision-making during an influenza pandemic: A modelling analysis, PLOS COMPUTATIONAL BIOLOGY, Vol: 19, ISSN: 1553-734X

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Arinaminpathy N, Rade K, Kumar R, Joshi RP, Rao Ret al., 2023, The potential impact of vaccination on tuberculosis burden in India: A modelling analysis, INDIAN JOURNAL OF MEDICAL RESEARCH, Vol: 157, Pages: 119-+, ISSN: 0971-5916

Journal article

Arinaminpathy N, Mukadi YD, Bloom A, Vincent C, Ahmedov Set al., 2023, Meeting the 2030 END TB goals in the wake of COVID-19: A modelling study of countries in the USAID TB portfolio., PLOS Glob Public Health, Vol: 3

Progress towards the 2030 End TB goals has seen severe setbacks due to disruptions arising from the COVID-19 pandemic. For governments and international partner organizations supporting the global TB response, there is a need to assess what level of effort is now needed to reach these goals. Using mathematical modelling, we addressed this question for the countries being supported by the United States Agency for International Development (USAID). We aggregated the 24 countries in the USAID portfolio into three geographical country groups: South Asia; sub-Saharan Africa; and Central Asian Republics/Europe (CAR/EU). From 2023 onwards we modelled a combination of interventions acting at different stages of the care cascade, including improved diagnostics; reducing the patient care seeking delay; and the rollout of a disease-preventing vaccine from 2025 onwards. We found that in all three country groups, meeting the End TB goals by 2030 will require a combination of interventions acting at stages of the TB care cascade. Specific priorities may depend on country settings, for example with public-private mix playing an important role in countries in South Asia and elsewhere. When a vaccine becomes available, its required coverage to meet the 2030 goals will vary by setting, depending on the amount of preventive therapy that has already been implemented. Monitoring the number-needed-to-test to identify 1 person with TB in community settings can provide a useful measure of progress towards the End TB goals.

Journal article

Baik Y, Cilloni L, Kendall E, Dowdy D, Arinaminpathy Net al., 2022, Symptom-based vs asymptomatic testing for controlling SARS-CoV-2 transmission in low- and middle-income countries: A modelling analysis, EPIDEMICS, Vol: 41, ISSN: 1755-4365

Journal article

Sahu S, Wandwalo E, Arinaminpathy N, 2022, Exploring the Impact of the COVID-19 Pandemic on Tuberculosis Care and Prevention, JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, Vol: 11, Pages: S67-S71, ISSN: 2048-7193

Journal article

Nsengiyumva NP, Campbell JR, Oxlade O, Vesga JF, Lienhardt C, Trajman A, Falzon D, Den Boon S, Arinaminpathy N, Schwartzman Ket al., 2022, Scaling up target regimens for tuberculosis preventive treatment in Brazil and South Africa: an analysis of costs and cost-effectiveness, PLoS Medicine, Vol: 19, ISSN: 1549-1277

BackgroundShorter, safer, and cheaper tuberculosis (TB) preventive treatment (TPT) regimens will enhance uptake and effectiveness. WHO developed target product profiles describing minimum requirements and optimal targets for key attributes of novel TPT regimens. We performed a cost-effectiveness analysis addressing the scale-up of regimens meeting these criteria in Brazil, a setting with relatively low transmission and low HIV and rifampicin-resistant TB (RR-TB) prevalence, and South Africa, a setting with higher transmission and higher HIV and RR-TB prevalence.Methods and findingsWe used outputs from a model simulating scale-up of TPT regimens meeting minimal and optimal criteria. We assumed that drug costs for minimal and optimal regimens were identical to 6 months of daily isoniazid (6H). The minimal regimen lasted 3 months, with 70% completion and 80% efficacy; the optimal regimen lasted 1 month, with 90% completion and 100% efficacy. Target groups were people living with HIV (PLHIV) on antiretroviral treatment and household contacts (HHCs) of identified TB patients. The status quo was 6H at 2019 coverage levels for PLHIV and HHCs. We projected TB cases and deaths, TB-associated disability-adjusted life years (DALYs), and costs (in 2020 US dollars) associated with TB from a TB services perspective from 2020 to 2035, with 3% annual discounting. We estimated the expected costs and outcomes of scaling up 6H, the minimal TPT regimen, or the optimal TPT regimen to reach all eligible PLHIV and HHCs by 2023, compared to the status quo. Maintaining current 6H coverage in Brazil (0% of HHCs and 30% of PLHIV treated) would be associated with 1.1 (95% uncertainty range [UR] 1.1–1.2) million TB cases, 123,000 (115,000–132,000) deaths, and 2.5 (2.1–3.1) million DALYs and would cost $1.1 ($1.0–$1.3) billion during 2020–2035. Expanding the 6H, minimal, or optimal regimen to 100% coverage among eligible groups would reduce DALYs by 0.5% (95% UR 1.2

Journal article

Vesga J, Lienhardt C, Nsengimyumva P, Campbell J, Oxlade O, den Boon S, Falzon D, Schwartzman K, Churchyard G, Arinaminpathy Net al., 2022, Prioritising attributes for tuberculosis preventive treatment regimens: a modelling analysis, BMC Medicine, Vol: 20, ISSN: 1741-7015

Background:Recent years have seen important improvements in available preventive treatment regimens for tuberculosis (TB), and research is ongoing to develop these further. To assist with the formulation of target product profiles for future regimens, we examined which regimen properties would be most influential in the epidemiological impact of preventive treatment.Methods:Following expert consultation, we identified 5 regimen properties relevant to the incidence-reducing impact of a future preventive treatment regimen: regimen duration, efficacy, ease-of-adherence (treatment completion rates in programmatic conditions), forgiveness to non-completion and the barrier to developing rifampicin resistance during treatment. For each regimen property, we elicited expert input for minimally acceptable and optimal (ideal-but-feasible) performance scenarios for future regimens. Using mathematical modelling, we then examined how each regimen property would influence the TB incidence reduction arising from full uptake of future regimens according to current WHO guidelines, in four countries: South Africa, Kenya, India and Brazil.Results:Of all regimen properties, efficacy is the single most important predictor of epidemiological impact, while ease-of-adherence plays an important secondary role. These results are qualitatively consistent across country settings; sensitivity analyses show that these results are also qualitatively robust to a range of model assumptions, including the mechanism of action of future preventive regimens.Conclusions:As preventive treatment regimens against TB continue to improve, understanding the key drivers of epidemiological impact can assist in guiding further development. By meeting these key targets, future preventive treatment regimens could play a critical role in global efforts to end TB.

Journal article

Mandal S, Parchani K, Arinaminpathy N, Sarkar S, Bhargava B, Panda Set al., 2022, 'Imperfect but useful': pandemic response in the Global South can benefit from greater use of mathematical modelling, BMJ GLOBAL HEALTH, Vol: 7, ISSN: 2059-7908

Journal article

Arinaminpathy N, Saad-Roy CM, Yang Q, Ahmad I, Yadav P, Grenfell Bet al., 2022, A global system for the next generation of vaccines COVID-19 has shown that hurdles can be overcome, Science, Vol: 376, Pages: 462-464, ISSN: 0036-8075

Journal article

Den Boon S, Lienhardt C, Zignol M, Schwartzman K, Arinaminpathy N, Campbell JR, Nahid P, Penazzato M, Menzies D, Vesga JF, Oxlade O, Churchyard G, Merle CS, Kasaeva T, Falzon Det al., 2022, WHO target product profiles for TB preventive treatment, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 26, Pages: 302-+, ISSN: 1027-3719

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Mandal S, Arinaminpathy N, Bhargava B, Panda Set al., 2021, Responsible travel to and within India during the COVID-19 pandemic, JOURNAL OF TRAVEL MEDICINE, Vol: 28, ISSN: 1195-1982

Journal article

Silva S, Arinaminpathy N, Atu R, Goosby E, Reid Met al., 2021, Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis (vol 9, pg e1372, 2021), LANCET GLOBAL HEALTH, Vol: 9, Pages: E1507-E1507, ISSN: 2214-109X

Journal article

Kendall EA, Arinaminpathy N, Sacks JA, Manabe YC, Dittrich S, Schumacher SG, Dowdy DWet al., 2021, Antigen-based Rapid Diagnostic Testing or Alternatives for Diagnosis of Symptomatic COVID-19 A Simulation-based Net Benefit Analysis, EPIDEMIOLOGY, Vol: 32, Pages: 811-819, ISSN: 1044-3983

Journal article

Shrestha S, Kendall EA, Chang R, Joseph R, Kasaie P, Gillini L, Fojo AT, Campbell M, Arinaminpathy N, Dowdy DWet al., 2021, Achieving a "step change" in the tuberculosis epidemic through comprehensive community-wide intervention: a model-based analysis, BMC MEDICINE, Vol: 19, ISSN: 1741-7015

Journal article

Arinaminpathy N, Nandi A, Shibu V, Nita J, Sreenivas N, Sameer K, Puneet D, Kiran R, Bhavin V, Raghuram R, Kuldeep Singh Set al., 2021, Engaging with the private healthcare sector for the control of tuberculosis in India: Cost and cost-effectiveness, BMJ Global Health, Vol: 6, Pages: 1-10, ISSN: 2059-7908

BackgroundThe control of tuberculosis (TB) in India is complicated by the presence of a large, disorganised private sector where most patients first seek care. Following pilots in Mumbai and Patna (two major cities in India), an initiative known as the ‘Public Private Interface Agency’ (PPIA) is now being expanded across the country. We aimed to estimate the cost-effectiveness of scaling up PPIA operations, in line with India’s National Strategic Plan for TB control.MethodsFocusing on Mumbai and Patna, we collected cost data from implementing organisations in both cities and combined this data with models of TB transmission dynamics. Estimating the cost per DALY averted between 2014 (the start of PPIA scale-up) and 2025, we assessed cost-effectiveness using two willingness-to-pay approaches: a WHO-CHOICE threshold based on per-capita economic productivity, and a more stringent threshold incorporating opportunity costs in the health system.FindingsA PPIA scaled up to ultimately reach 50% of privately-treated TB patients in Mumbai and Patna would cost, respectively, USD 228 (95% C.I. 159 – 320) per DALY averted and USD 564 (95% C.I. 409 - 775) per DALY averted. In Mumbai, the PPIA would be cost-effective relative to all thresholds considered. In Patna, if focusing on adherence support, rather than on improved diagnosis, the PPIA would be cost-effective relative to all thresholds considered. These differences between sites arise from variations in the burden of drug resistance: amongst the services of a PPIA, improved diagnosis (including rapid tests with genotypic drug sensitivity testing) has greatest value in settings such as Mumbai, with a high burden of drug-resistant TB.ConclusionsTo accelerate decline in TB incidence, it is critical first to engage effectively with the private sector in India. Mechanisms such as the PPIA offer cost-effective ways of doing so, particularly when tailored to local settings.

Journal article

Silva S, Arinaminpathy N, Atun R, Goosby E, Reid Met al., 2021, Economic impact of tuberculosis mortality in 120 countries and the cost of not achieving the Sustainable Development Goals tuberculosis targets: a full-income analysis, LANCET GLOBAL HEALTH, Vol: 9, Pages: E1372-E1379, ISSN: 2214-109X

Journal article

Arinaminpathy N, Das J, McCormick T, Mukhopadhyay P, Sircar Net al., 2021, Quantifying heterogeneity in SARS-CoV-2 transmission during the lockdown in India, Epidemics: the journal of infectious disease dynamics, Vol: 36, Pages: 1-7, ISSN: 1755-4365

The novel SARS-CoV-2 virus, as it manifested in India in April 2020, showed marked heterogeneity in its transmission. Here, we used data collected from contact tracing during the lockdown in response to the first wave of COVID-19 in Punjab, a major state in India, to quantify this heterogeneity, and to examine implications for transmission dynamics. We found evidence of heterogeneity acting at multiple levels: in the number of potentially infectious contacts per index case, and in the per-contact risk of infection. Incorporating these findings in simple mathematical models of disease transmission reveals that these heterogeneities act in combination to strongly influence transmission dynamics. Standard approaches, such as representing heterogeneity through secondary case distributions, could be biased by neglecting these underlying interactions between heterogeneities. We discuss implications for policy, and for more efficient contact tracing in resource-constrained settings such as India. Our results highlight how contact tracing, an important public health measure, can also provide important insights into epidemic spread and control.

Journal article

Mandal S, Arinaminpathy N, Bhargava B, Panda Set al., 2021, Responsive and agile vaccination strategies against COVID-19 in India, LANCET GLOBAL HEALTH, Vol: 9, Pages: E1197-E1200, ISSN: 2214-109X

Journal article

Mandal S, Arinaminpathy N, Bhargava B, Panda Set al., 2021, Plausibility of a third wave of COVID-19 in India: A mathematical modelling based analysis, INDIAN JOURNAL OF MEDICAL RESEARCH, Vol: 153, Pages: 522-+, ISSN: 0971-5916

Journal article

Mandal S, Arinaminpathy N, Bhargava B, Panda Set al., 2021, Plausibility of a third wave of COVID-19 in India: A mathematical modelling based analysis., Indian J Med Res, Vol: 153, Pages: 522-532

BACKGROUND & OBJECTIVES: In the context of India's ongoing resurgence of COVID-19 (second wave since mid-February 2021, following the subsiding of the first wave in September 2020), there has been increasing speculation on the possibility of a future third wave of infection, posing a burden on the healthcare system. Using simple mathematical models of the transmission dynamics of SARS-CoV-2, this study examined the conditions under which a serious third wave could occur. METHODS: Using a deterministic, compartmental model of SARS-CoV-2 transmission, four potential mechanisms for a third wave were examined: (i) waning immunity restores previously exposed individuals to a susceptible state, (ii) emergence of a new viral variant that is capable of escaping immunity to previously circulating strains, (iii) emergence of a new viral variant that is more transmissible than the previously circulating strains, and (iv) release of current lockdowns affording fresh opportunities for transmission. RESULTS: Immune-mediated mechanisms (waning immunity, or viral evolution for immune escape) are unlikely to drive a severe third wave if acting on their own, unless such mechanisms lead to a complete loss of protection among those previously exposed. Likewise, a new, more transmissible variant would have to exceed a high threshold (R0>4.5) to cause a third wave on its own. However, plausible mechanisms for a third wave include: (i) a new variant that is more transmissible and at the same time capable of escaping prior immunity, and (ii) lockdowns that are highly effective in limiting transmission and subsequently released. In both cases, any third wave seems unlikely to be as severe as the second wave. Rapid scale-up of vaccination efforts could play an important role in mitigating these and future waves of the disease. INTERPRETATION & CONCLUSIONS: This study demonstrates plausible mechanisms by which a substantial third wave could occur, while also illustrating that it is

Journal article

Ricks S, Kendall EA, Dowdy DW, Sacks JA, Schumacher SG, Arinaminpathy Net al., 2021, Quantifying the potential value of antigen-detection rapid diagnostic tests for COVID-19: a modelling analysis, BMC Medicine, Vol: 19, Pages: 1-13, ISSN: 1741-7015

BackgroundTesting plays a critical role in treatment and prevention responses to the COVID-19 pandemic. Compared to nucleic acid tests (NATs), antigen-detection rapid diagnostic tests (Ag-RDTs) can be more accessible, but typically have lower sensitivity and specificity. By quantifying these trade-offs, we aimed to inform decisions about when an Ag-RDT would offer greater public health value than reliance on NAT. MethodsFollowing an expert consultation, we selected two use cases for analysis: rapid identification of people with COVID-19 amongst patients admitted with respiratory symptoms in a ‘hospital’ setting; and early identification and isolation of people with mildly symptomatic COVID-19 in a ‘community’ setting. Using decision analysis, we evaluated the health system cost and health impact (deaths averted and infectious days isolated) of an Ag-RDT-led strategy, compared to a strategy based on NAT and clinical judgment. We adopted a broad range of values for ‘contextual’ parameters relevant to a range of settings, including the availability of NAT, the performance of clinical judgement, etc. We performed a multivariate sensitivity analysis to all of these parameters. ResultsIn a hospital setting, an Ag-RDT-led strategy would avert more deaths than a NAT-based strategy, and at lower cost per death averted, when the sensitivity of clinical judgement is less than 85%, and when NAT results are available in time to inform clinical decision-making for less than 90% of patients. The use of an Ag-RDT is robustly supported in community settings, where it would avert more transmission at lower cost than relying on NAT alone, under a wide range of assumptions. ConclusionsDespite their imperfect sensitivity and specificity, Ag-RDTs have the potential to be simultaneously more impactful, and have a lower cost per death and infectious person-days averted, than current approaches to COVID-19 diagnostic testing.

Journal article

Mandal S, Das H, Deo S, Arinaminpathy Net al., 2021, Combining serology with case-detection, to allow the easing of restrictions against SARS-CoV-2: a modelling-based study in India, Scientific Reports, Vol: 11, Pages: 1-9, ISSN: 2045-2322

India’s lockdown against SARS-CoV-2, if lifted without any other mitigations in place, could risk a second wave of infection. A test-and-isolate strategy, using PCR diagnostic tests, could help to minimise the impact of this second wave. Meanwhile, population-level serological surveillance can provide valuable insights into the level of immunity in the population. Using a mathematical model, consistent with an Indian megacity, we examined how seroprevalence data could guide a test-and-isolate strategy, for lifting a lockdown. For example, if seroprevalence is 20% of the population, we show that a testing strategy needs to identify symptomatic cases within 5 – 8 days of symptom onset, in order to prevent a resurgent wave from overwhelming hospital capacity in the city. This estimate is robust to uncertainty in the effectiveness of the lockdown, as well as in immune protection against reinfection. To set these results in their economic context, we estimate that the weekly cost of such a PCR-based testing programme would be less than 2.1% of the weekly economic loss due to the lockdown. Our results illustrate how PCR-based testing and serological surveillance can be combined to design evidence-based policies, for lifting lockdowns in Indian cities and elsewhere.

Journal article

Fu H, Lewnard JA, Frost I, Laxminarayan R, Arinaminpathy Net al., 2021, Modelling the global burden of drug-resistant tuberculosis avertable by a post-exposure vaccine, Nature Communications, Vol: 12, Pages: 1-9, ISSN: 2041-1723

There have been notable advances in the development of vaccines against active tuberculosis (TB) disease for adults and adolescents. Using mathematical models, we seek to estimate the potential impact of a post-exposure TB vaccine, having 50% efficacy in reducing active disease, on global rifampicin-resistant (RR-) TB burden. In 30 countries that together accounted for 90% of global RR-TB incidence in 2018, a future TB vaccine could avert 10% (95% credible interval: 9.7–11%) of RR-TB cases and 7.3% (6.6–8.1%) of deaths over 2020–2035, with India, China, Indonesia, Pakistan, and the Russian Federation having the greatest contribution. This impact would increase to 14% (12–16%) and 31% (29–33%) respectively, when combined with improvements in RR-TB diagnosis and treatment relative to a scenario of no vaccine and no such improvements. A future TB vaccine could have important implications for the global control of RR-TB, especially if implemented alongside enhancements in management of drug resistance.

Journal article

Mandal S, Arinaminpathy N, Bhargava B, Panda Set al., 2021, India's pragmatic vaccination strategy against COVID-19: a mathematical modelling-based analysis, BMJ OPEN, Vol: 11, ISSN: 2044-6055

Journal article

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