Evaluating health and economic effects of targeted strategies in TB/HIV
评估结核病/艾滋病毒针对性策略的健康和经济影响
基本信息
- 批准号:8876577
- 负责人:
- 金额:$ 59.16万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2014
- 资助国家:美国
- 起止时间:2014-07-01 至 2018-06-30
- 项目状态:已结题
- 来源:
- 关键词:AccountingAddressAfrica South of the SaharaAfricanCharacteristicsClinicalCommunitiesConsensusCosts and BenefitsCountryDevelopmentDiagnosisDiseaseDrug resistanceEffectivenessEpidemicEquationGeographic LocationsGoalsHIVHIV SeropositivityHeterogeneityImpact evaluationIncidenceIndividualInfectionInternationalInterventionLifeLightLung diseasesModelingMonitorMorbidity - disease rateNatural HistoryPatientsPhenotypePoliciesPolicy MakerPopulationPopulation InterventionPrevalencePreventiveRandomizedReactionRecommendationResearchResearch ActivityResearch PersonnelResourcesReview LiteratureRiskRisk FactorsTestingTuberculin TestTuberculosisUpdateWorld Health Organizationbasecase findingcomparative effectivenesscostcost effectivecost effectivenessdesigneconomic costhealth economicshigh riskimprovedinnovationisoniazidmathematical modelmeetingsmodels and simulationmortalitymultidisciplinarypathogenprogramsprospectivepublic health relevancescreeningtargeted treatmenttooltransmission process
项目摘要
DESCRIPTION (provided by applicant): The HIV epidemic has triggered a sharp increase in the burden of tuberculosis (TB) in sub-Saharan Africa. An emerging consensus suggests that the conventional strategy for global TB control, based on passive identification of individuals with active pulmonary disease, may not be sufficiently aggressive to address HIV-fuelled TB epidemics. As a result, the World Health Organization has updated recommendations to support wider use of treatment for latent M. tuberculosis infection (TLTBI) and more active screening for TB disease, as two key components of a new strategic approach for control of HIV-associated TB epidemics. Community-randomized studies testing these strategies on a broad population-wide scale, have produced disappointing results thus far. We hypothesize that targeted use of TLTBI and active TB case-finding may prove more effective, and more cost-effective, than non-targeted use. Our overall goal in this project is to use mathematical models of TB and HIV epidemics to examine this hypothesis and evaluate the comparative effectiveness and efficiency of alternative choices in the design and implementation of targeted strategies. Toward this goal our project has three specific aims: (1) To develop a detailed simulation model of TB/HIV co-epidemics and calibrate the model to 9 high burden countries in sub-Saharan Africa. (2) To use this model to identify strategies for effective and cost-effective use of targeted screening for active tuberculosis. (3) To use this model to identify strategies for effective and cost-effective use of targeted TLTBI. Mathematical models can provide a unique approach to consolidate information from available studies to compare the projected effects (and costs) of alternative strategies for targeting and combining screening interventions. The models we propose aim to meet this critical need and supply new tools to inform development and revision of national and international strategies for deploying interventions that can maximize impact and value for money when used singly and in combination. We expect this study to provide essential information for policy makers and researchers seeking to identify key priorities and set targets for tuberculosis control in settings of high HIV prevalence. In addition to providing evidence with
immediate relevance to policy, the approach developed in this study will provide a durable template for further analyses, including prospective assessment of other targeted or general TB control strategies; retrospective evaluation of the impact and cost- effectiveness of programs; and monitoring of progress towards key goals for reducing the burdens of TB and HIV in resource limited settings.
描述(由申请人提供):艾滋病毒的流行引发了撒哈拉以南非洲结核病(TB)负担的急剧增加。一个正在形成的共识表明,基于被动识别活动性肺病个体的全球结核病控制传统战略可能不足以积极应对艾滋病毒引发的结核病流行。因此,世界卫生组织更新了建议,以支持更广泛地使用潜伏性M。结核感染(TLTBI)和更积极的结核病筛查是控制艾滋病毒相关结核病流行的新战略方法的两个关键组成部分。社区随机研究在广泛的人群范围内测试这些策略,迄今为止产生了令人失望的结果。我们假设,有针对性地使用TLTBI和活动性结核病病例发现可能比非有针对性地使用更有效,更具成本效益。我们在这个项目中的总体目标是使用结核病和艾滋病流行的数学模型来检验这一假设,并评估在设计和实施有针对性的战略中替代选择的相对有效性和效率。为了实现这一目标,我们的项目有三个具体目标:(1)开发一个详细的结核病/艾滋病合并流行病的模拟模型,并将该模型校准到撒哈拉以南非洲的9个高负担国家。(2)利用这一模式,以确定战略,有效和具有成本效益的使用有针对性的筛查活动性结核病。(3)使用该模型来确定有效和具有成本效益地使用目标TLTBI的策略。数学模型可以提供一种独特的方法来整合现有研究的信息,以比较针对和组合筛查干预措施的替代战略的预测效果(和成本)。我们提出的模型旨在满足这一关键需求,并提供新的工具,为制定和修订国家和国际干预战略提供信息,这些干预措施在单独使用和组合使用时可以最大限度地发挥影响和资金价值。我们希望这项研究能够为政策制定者和研究人员提供必要的信息,以便在艾滋病毒高流行率的环境中确定结核病控制的关键优先事项和目标。除了提供证据外,
由于与政策的直接相关性,本研究中开发的方法将为进一步分析提供持久的模板,包括对其他有针对性的或一般的结核病控制策略的前瞻性评估; 2对计划的影响和成本效益的回顾性评估; 3以及监测在资源有限的情况下实现减少结核病和艾滋病毒负担的关键目标的进展。
项目成果
期刊论文数量(0)
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专利数量(0)
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{{ truncateString('THEODORE H COHEN', 18)}}的其他基金
Integrating genomic and spatial approaches for targeted control of HIV-associated tuberculosis epidemics
整合基因组和空间方法有针对性地控制艾滋病毒相关结核病流行
- 批准号:
10456759 - 财政年份:2020
- 资助金额:
$ 59.16万 - 项目类别:
Integrating genomic and spatial approaches for targeted control of HIV-associated tuberculosis epidemics
整合基因组和空间方法有针对性地控制艾滋病毒相关结核病流行
- 批准号:
10057051 - 财政年份:2020
- 资助金额:
$ 59.16万 - 项目类别:
Integrating genomic and spatial approaches for targeted control of HIV-associated tuberculosis epidemics
整合基因组和空间方法有针对性地控制艾滋病毒相关结核病流行
- 批准号:
10676990 - 财政年份:2020
- 资助金额:
$ 59.16万 - 项目类别:
Integrating genomic and spatial approaches for targeted control of HIV-associated tuberculosis epidemics
整合基因组和空间方法有针对性地控制艾滋病毒相关结核病流行
- 批准号:
10225637 - 财政年份:2020
- 资助金额:
$ 59.16万 - 项目类别:
Evaluating health and economic effects of targeted strategies in TB/HIV
评估结核病/艾滋病毒针对性策略的健康和经济影响
- 批准号:
9088323 - 财政年份:2014
- 资助金额:
$ 59.16万 - 项目类别:
Evaluating health and economic effects of targeted strategies in TB/HIV
评估结核病/艾滋病毒针对性策略的健康和经济影响
- 批准号:
8951893 - 财政年份:2014
- 资助金额:
$ 59.16万 - 项目类别:
Prevalence, risk factors and consequences of complex M. Tuberculosis infections
复杂结核分枝杆菌感染的患病率、危险因素和后果
- 批准号:
7852706 - 财政年份:2010
- 资助金额:
$ 59.16万 - 项目类别:
Molecular approaches for understanding TB dynamics
了解结核病动态的分子方法
- 批准号:
6781932 - 财政年份:2004
- 资助金额:
$ 59.16万 - 项目类别:
Molecular approaches for understanding TB dynamics
了解结核病动态的分子方法
- 批准号:
7198010 - 财政年份:2004
- 资助金额:
$ 59.16万 - 项目类别:
Molecular approaches for understanding TB dynamics
了解结核病动态的分子方法
- 批准号:
7013597 - 财政年份:2004
- 资助金额:
$ 59.16万 - 项目类别:
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