Imperial College London
Alternate

Professor Nimalan Arinaminpathy (Nim Pathy)

Faculty of Medicine, School 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

Citation

BibTex format

@article{Nsengiyumva:2022:10.1371/journal.pmed.1004032,
author = {Nsengiyumva, NP and Campbell, JR and Oxlade, O and Vesga, JF and Lienhardt, C and Trajman, A and Falzon, D and Den, Boon S and Arinaminpathy, N and Schwartzman, K},
doi = {10.1371/journal.pmed.1004032},
journal = {PLoS Medicine},
title = {Scaling up target regimens for tuberculosis preventive treatment in Brazil and South Africa: an analysis of costs and cost-effectiveness},
url = {http://dx.doi.org/10.1371/journal.pmed.1004032},
volume = {19},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - 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
AU  - Nsengiyumva,NP
AU  - Campbell,JR
AU  - Oxlade,O
AU  - Vesga,JF
AU  - Lienhardt,C
AU  - Trajman,A
AU  - Falzon,D
AU  - Den,Boon S
AU  - Arinaminpathy,N
AU  - Schwartzman,K
DO  - 10.1371/journal.pmed.1004032
PY  - 2022///
SN  - 1549-1277
TI  - Scaling up target regimens for tuberculosis preventive treatment in Brazil and South Africa: an analysis of costs and cost-effectiveness
T2  - PLoS Medicine
UR  - http://dx.doi.org/10.1371/journal.pmed.1004032
UR  - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000828097600002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=a2bf6146997ec60c407a63945d4e92bb
UR  - https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004032
UR  - http://hdl.handle.net/10044/1/106788
VL  - 19
ER  -
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