Imperial College London
Portrait Picture

ProfessorTimothyHallett

Faculty of Medicine, School of Public Health

Professor of Global Health
 
 
 
//

Contact

 

+44 (0)20 7594 1150timothy.hallett

 
 
//

Location

 

School of Public HealthWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Ricks:2020:10.1371/journal.pmed.1003466,
author = {Ricks, S and Denkinger, CM and Schumacher, SG and Hallett, TB and Arinaminpathy, N},
doi = {10.1371/journal.pmed.1003466},
journal = {PLoS Medicine},
title = {The potential impact of urine-LAM diagnostics on tuberculosis incidence and mortality: a modelling analysis},
url = {http://dx.doi.org/10.1371/journal.pmed.1003466},
volume = {17},
year = {2020}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundLateral flow urine lipoarabinomannan (LAM) tests could offer important new opportunities for the early detection of tuberculosis (TB). The currently licensed LAM test, Alere Determine TB LAM Ag (‘LF-LAM’), performs best in the sickest people living with HIV (PLHIV). However, the technology continues to improve, with newer LAM tests, such as Fujifilm SILVAMP TB LAM (‘SILVAMP-LAM’) showing improved sensitivity, including amongst HIV-negative patients. It is important to anticipate the epidemiological impact that current and future LAM tests may have on TB incidence and mortality.Methods and findingsConcentrating on South Africa, we examined the impact that widening LAM test eligibility would have on TB incidence and mortality. We developed a mathematical model of TB transmission to project the impact of LAM tests, distinguishing ‘current’ tests (with sensitivity consistent with LF-LAM), from hypothetical ‘future’ tests (having sensitivity consistent with SILVAMP-LAM). We modelled the impact of both tests, assuming full adoption of the 2019 WHO guidelines for the use of these tests amongst those receiving HIV care. We also simulated the hypothetical deployment of future LAM tests for all people presenting to care with TB symptoms, not restricted to PLHIV. Our model projects that 2,700,000 (95% credible interval [CrI] 2,000,000–3,600,000) and 420,000 (95% CrI 350,000–520,000) cumulative TB incident cases and deaths, respectively, would occur between 2020 and 2035 if the status quo is maintained. Relative to this comparator, current and future LAM tests would respectively avert 54 (95% CrI 33–86) and 90 (95% CrI 55–145) TB deaths amongst inpatients between 2020 and 2035, i.e., reductions of 5% (95% CrI 4%–6%) and 9% (95% CrI 7%–11%) in inpatient TB mortality. This impact in absolute deaths averted doubles if testing is expanded to include outpatients, yet remains <1% of count
AU  - Ricks,S
AU  - Denkinger,CM
AU  - Schumacher,SG
AU  - Hallett,TB
AU  - Arinaminpathy,N
DO  - 10.1371/journal.pmed.1003466
PY  - 2020///
SN  - 1549-1277
TI  - The potential impact of urine-LAM diagnostics on tuberculosis incidence and mortality: a modelling analysis
T2  - PLoS Medicine
UR  - http://dx.doi.org/10.1371/journal.pmed.1003466
UR  - http://hdl.handle.net/10044/1/85040
VL  - 17
ER  -
Download