The Lancet Global Health (Nov 2016)
Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models
- Dr. Rein M G J Houben, PhD,
- Nicolas A Menzies, PhD,
- Tom Sumner, PhD,
- Grace H Huynh, PhD,
- Nimalan Arinaminpathy, PhD,
- Jeremy D Goldhaber-Fiebert, PhD,
- Hsien-Ho Lin, PhD,
- Chieh-Yin Wu, MS,
- Sandip Mandal, PhD,
- Surabhi Pandey, PhD,
- Sze-chuan Suen, MS,
- Eran Bendavid, MD,
- Andrew S Azman, PhD,
- David W Dowdy, PhD,
- Nicolas Bacaër, PhD,
- Allison S Rhines, PhD,
- Prof. Marcus W Feldman, PhD,
- Andreas Handel, PhD,
- Prof. Christopher C Whalen, MD,
- Stewart T Chang, PhD,
- Bradley G Wagner, PhD,
- Philip A Eckhoff, PhD,
- James M Trauer, PhD,
- Justin T Denholm, PhD,
- Prof. Emma S McBryde, PhD,
- Ted Cohen, DPH,
- Prof. Joshua A Salomon, PhD,
- Carel Pretorius, PhD,
- Marek Lalli, MSc,
- Jeffrey W Eaton, PhD,
- Delia Boccia, PhD,
- Mehran Hosseini, MD,
- Gabriela B Gomez, PhD,
- Suvanand Sahu, MD,
- Colleen Daniels, MA,
- Lucica Ditiu, MD,
- Daniel P Chin, MD,
- Lixia Wang, MS,
- Vineet K Chadha, MD,
- Kiran Rade, MPhil,
- Puneet Dewan, MD,
- Piotr Hippner, MSc,
- Salome Charalambous, PhD,
- Prof. Alison D Grant,
- Prof. Gavin Churchyard, PhD,
- Yogan Pillay, PhD,
- L David Mametja, MPH,
- Michael E Kimerling, MD,
- Anna Vassall, PhD,
- Richard G White, PhD
Affiliations
- Dr. Rein M G J Houben, PhD
- TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, UK
- Nicolas A Menzies, PhD
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
- Tom Sumner, PhD
- TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, UK
- Grace H Huynh, PhD
- Institute for Disease Modeling, Seattle, WA, USA
- Nimalan Arinaminpathy, PhD
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Jeremy D Goldhaber-Fiebert, PhD
- Stanford Health Policy, Centers for Health Policy and Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA
- Hsien-Ho Lin, PhD
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Chieh-Yin Wu, MS
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
- Sandip Mandal, PhD
- Public Health Foundation of India, Delhi NCR, India
- Surabhi Pandey, PhD
- Public Health Foundation of India, Delhi NCR, India
- Sze-chuan Suen, MS
- Management Science and Engineering Dept, Stanford University, Stanford, CA, USA
- Eran Bendavid, MD
- Department of Medicine, Stanford University, Stanford, CA, USA
- Andrew S Azman, PhD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- David W Dowdy, PhD
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Nicolas Bacaër, PhD
- IRD, UMMISCO, Bondy, France
- Allison S Rhines, PhD
- Department of Biology, Stanford University, Stanford, CA, USA
- Prof. Marcus W Feldman, PhD
- Department of Biology, Stanford University, Stanford, CA, USA
- Andreas Handel, PhD
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
- Prof. Christopher C Whalen, MD
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
- Stewart T Chang, PhD
- Institute for Disease Modeling, Seattle, WA, USA
- Bradley G Wagner, PhD
- Institute for Disease Modeling, Seattle, WA, USA
- Philip A Eckhoff, PhD
- Institute for Disease Modeling, Seattle, WA, USA
- James M Trauer, PhD
- The Burnet Institute, Melbourne, Australia
- Justin T Denholm, PhD
- The Victorian Infectious Diseases Service, at the Peter Doherty Institute, Melbourne, Australia
- Prof. Emma S McBryde, PhD
- The Burnet Institute, Melbourne, Australia
- Ted Cohen, DPH
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
- Prof. Joshua A Salomon, PhD
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
- Carel Pretorius, PhD
- Avenir Health, Glastonbury, CT, USA
- Marek Lalli, MSc
- TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, UK
- Jeffrey W Eaton, PhD
- Department of Infectious Disease Epidemiology, Imperial College London, London, UK
- Delia Boccia, PhD
- Faculty of Epidemiology and Public Health, London School of Hygiene and Tropical Medicine, London, UK
- Mehran Hosseini, MD
- Strategic Information Department, The Global Fund, Geneva, Switzerland
- Gabriela B Gomez, PhD
- Department of Global Health, University of Amsterdam, Amsterdam, Netherlands
- Suvanand Sahu, MD
- Stop TB Partnership, Geneva, Switzerland
- Colleen Daniels, MA
- Stop TB Partnership, Geneva, Switzerland
- Lucica Ditiu, MD
- Stop TB Partnership, Geneva, Switzerland
- Daniel P Chin, MD
- Bill and Melinda Gates Foundation, China Office, Beijing, China
- Lixia Wang, MS
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Vineet K Chadha, MD
- Epidemiology and Research Division, National Tuberculosis Institute, Bangalore, India
- Kiran Rade, MPhil
- World Health Organization, Country Office for India, New Delhi, India
- Puneet Dewan, MD
- The Bill & Melinda Gates Foundation, New Delhi, India
- Piotr Hippner, MSc
- Aurum Institute. Johannesburg, South Africa
- Salome Charalambous, PhD
- Aurum Institute. Johannesburg, South Africa
- Prof. Alison D Grant
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
- Prof. Gavin Churchyard, PhD
- Aurum Institute. Johannesburg, South Africa
- Yogan Pillay, PhD
- National Department of Health, Pretoria, South Africa
- L David Mametja, MPH
- National Department of Health, Pretoria, South Africa
- Michael E Kimerling, MD
- Bill and Melinda Gates foundation, Seattle, WA, USA (currently KNCV Tuberculosisn Foundation, The Hague, Netherlands)
- Anna Vassall, PhD
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- Richard G White, PhD
- TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, UK
- DOI
- https://doi.org/10.1016/S2214-109X(16)30199-1
- Journal volume & issue
-
Vol. 4,
no. 11
pp. e806 – e815
Abstract
Background: The post-2015 End TB Strategy proposes targets of 50% reduction in tuberculosis incidence and 75% reduction in mortality from tuberculosis by 2025. We aimed to assess whether these targets are feasible in three high-burden countries with contrasting epidemiology and previous programmatic achievements. Methods: 11 independently developed mathematical models of tuberculosis transmission projected the epidemiological impact of currently available tuberculosis interventions for prevention, diagnosis, and treatment in China, India, and South Africa. Models were calibrated with data on tuberculosis incidence and mortality in 2012. Representatives from national tuberculosis programmes and the advocacy community provided distinct country-specific intervention scenarios, which included screening for symptoms, active case finding, and preventive therapy. Findings: Aggressive scale-up of any single intervention scenario could not achieve the post-2015 End TB Strategy targets in any country. However, the models projected that, in the South Africa national tuberculosis programme scenario, a combination of continuous isoniazid preventive therapy for individuals on antiretroviral therapy, expanded facility-based screening for symptoms of tuberculosis at health centres, and improved tuberculosis care could achieve a 55% reduction in incidence (range 31–62%) and a 72% reduction in mortality (range 64–82%) compared with 2015 levels. For India, and particularly for China, full scale-up of all interventions in tuberculosis-programme performance fell short of the 2025 targets, despite preventing a cumulative 3·4 million cases. The advocacy scenarios illustrated the high impact of detecting and treating latent tuberculosis. Interpretation: Major reductions in tuberculosis burden seem possible with current interventions. However, additional interventions, adapted to country-specific tuberculosis epidemiology and health systems, are needed to reach the post-2015 End TB Strategy targets at country level. Funding: Bill and Melinda Gates Foundation
