Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation

Parastu Kasaie; Hojoon Sohn; Emily Kendall; Gabriela B. Gomez; Anna Vassall; Madhukar Pai; David W. Dowdy

doi:10.1109/WSC.2017.8247858

Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation

Parastu Kasaie, Hojoon Sohn, Emily Kendall, Gabriela B. Gomez, Anna Vassall, Madhukar Pai, David W. Dowdy

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

1 Scopus citations

Abstract

Many high-burden countries have committed to providing universal access to rapid diagnosis of tuberculosis (TB), but the corresponding impact on population-wide incidence is unknown. We designed an agent-based simulation of drug-susceptible (DS) and drug-resistant (DR) TB in a representative Indian setting and compared the impact of Xpert testing via a decentralized (Xpert available at each local-population) versus centralized (Xpert available at the district-level serving multiple local-populations) strategy. Decentralized testing resulted in a 36% reduction in DR-TB incidence at 10 years compared to no Xpert. Depending on assumptions regarding pre-treatment loss to follow-up (ranging from 5 to 50%), the impact of centralized testing ranged from a 35% to 22% reduction in DR-TB incidence. Implementation of Xpert by either approach had a negligible impact (<5%) on DS-TB incidence. Decisions regarding choice of centralized vs. decentralized Xpert will heavily depend on operational aspects of centralized Xpert and loss to follow-up.

Original language	English (US)
Title of host publication	2017 Winter Simulation Conference, WSC 2017
Publisher	Institute of Electrical and Electronics Engineers Inc.
Pages	1097-1108
Number of pages	12
Volume	Part F134102
ISBN (Electronic)	9781538634288
DOIs	https://doi.org/10.1109/WSC.2017.8247858
State	Published - Jan 4 2018
Event	2017 Winter Simulation Conference, WSC 2017 - Las Vegas, United States Duration: Dec 3 2017 → Dec 6 2017

Other

Other	2017 Winter Simulation Conference, WSC 2017
Country/Territory	United States
City	Las Vegas
Period	12/3/17 → 12/6/17

ASJC Scopus subject areas

Software
Modeling and Simulation
Computer Science Applications

Access to Document

10.1109/WSC.2017.8247858

Cite this

Kasaie, P., Sohn, H., Kendall, E., Gomez, G. B., Vassall, A., Pai, M., & Dowdy, D. W. (2018). Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation. In 2017 Winter Simulation Conference, WSC 2017 (Vol. Part F134102, pp. 1097-1108). Institute of Electrical and Electronics Engineers Inc.. https://doi.org/10.1109/WSC.2017.8247858

Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation. / Kasaie, Parastu; Sohn, Hojoon; Kendall, Emily et al.
2017 Winter Simulation Conference, WSC 2017. Vol. Part F134102 Institute of Electrical and Electronics Engineers Inc., 2018. p. 1097-1108.

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

Kasaie, P, Sohn, H, Kendall, E, Gomez, GB, Vassall, A, Pai, M & Dowdy, DW 2018, Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation. in 2017 Winter Simulation Conference, WSC 2017. vol. Part F134102, Institute of Electrical and Electronics Engineers Inc., pp. 1097-1108, 2017 Winter Simulation Conference, WSC 2017, Las Vegas, United States, 12/3/17. https://doi.org/10.1109/WSC.2017.8247858

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abstract = "Many high-burden countries have committed to providing universal access to rapid diagnosis of tuberculosis (TB), but the corresponding impact on population-wide incidence is unknown. We designed an agent-based simulation of drug-susceptible (DS) and drug-resistant (DR) TB in a representative Indian setting and compared the impact of Xpert testing via a decentralized (Xpert available at each local-population) versus centralized (Xpert available at the district-level serving multiple local-populations) strategy. Decentralized testing resulted in a 36% reduction in DR-TB incidence at 10 years compared to no Xpert. Depending on assumptions regarding pre-treatment loss to follow-up (ranging from 5 to 50%), the impact of centralized testing ranged from a 35% to 22% reduction in DR-TB incidence. Implementation of Xpert by either approach had a negligible impact (<5%) on DS-TB incidence. Decisions regarding choice of centralized vs. decentralized Xpert will heavily depend on operational aspects of centralized Xpert and loss to follow-up.",

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AB - Many high-burden countries have committed to providing universal access to rapid diagnosis of tuberculosis (TB), but the corresponding impact on population-wide incidence is unknown. We designed an agent-based simulation of drug-susceptible (DS) and drug-resistant (DR) TB in a representative Indian setting and compared the impact of Xpert testing via a decentralized (Xpert available at each local-population) versus centralized (Xpert available at the district-level serving multiple local-populations) strategy. Decentralized testing resulted in a 36% reduction in DR-TB incidence at 10 years compared to no Xpert. Depending on assumptions regarding pre-treatment loss to follow-up (ranging from 5 to 50%), the impact of centralized testing ranged from a 35% to 22% reduction in DR-TB incidence. Implementation of Xpert by either approach had a negligible impact (<5%) on DS-TB incidence. Decisions regarding choice of centralized vs. decentralized Xpert will heavily depend on operational aspects of centralized Xpert and loss to follow-up.

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Exploring the epidemiological impact of universal access to rapid tuberculosis diagnosis using agent-based simulation

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