How can mathematical models advance tuberculosis control in high HIV prevalence settings?

Rein M.G.J. Houben, D. W. Dowdy, A. Vassall, T. Cohen, M. P. Nicol, R. M. Granich, J. E. Shea, P. Eckhoff, C. Dye, M. E. Kimerling, R. G. White

Research output: Contribution to journalReview articlepeer-review

Abstract

Existing approaches to tuberculosis (TB) control have been no more than partially successful in areas with high human immunodeficiency virus (HIV) prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing those strategies that are most likely to bring public health and economic benefits. In this paper, we present an overview of past and recent contributions of TB modelling in this key area, and suggest a way forward through a modelling research agenda that supports a more effective response to the TB-HIVepidemic, based on expert discussions at a meeting convened by the TB Modelling and Analysis Consortium. The research agenda identified highpriority areas for future modelling efforts, including 1) the difficult diagnosis and high mortality of TB-HIV; 2) the high risk of disease progression; 3) TB health systems in high HIV prevalence settings; 4) uncertainty in the natural progression of TB-HIV; and 5) combined interventions for TB-HIV. Efficient and rapid progress towards completion of this modelling agenda will require co-ordination between the modelling community and key stakeholders, including advocates, health policy makers, donors and national or regional finance officials. A continuing dialogue will ensure that new results are effectively communicated and new policy-relevant questions are addressed swiftly.

Original languageEnglish (US)
Pages (from-to)509-514+i
JournalInternational Journal of Tuberculosis and Lung Disease
Volume18
Issue number5
DOIs
StatePublished - May 1 2014

Keywords

  • HIV
  • Mathematical modelling
  • Sub-Saharan Africa
  • Systematic literature review
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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