Modelling the potential impact of adherence technologies on tuberculosis in India.
Int J Tuberc Lung Dis
; 24(5): 526-533, 2020 05 01.
Article
em En
| MEDLINE
| ID: mdl-32398203
ABSTRACT
BACKGROUND:
For patients taking standard first-line tuberculosis treatment, missing 10% or more of their doses increases the risk of relapse six-fold. Digital technologies offer new approaches to adherence support for TB patients. We estimated the potential impact of new adherence technologies in India.METHOD:
We developed a mathematical model of TB transmission dynamics in India, capturing the independent effects of missed doses and treatment default on post-treatment recurrence. We simulated the impact of interventions to address both missed doses and treatment default in the public and private healthcare sector.RESULTS:
Adherence interventions, if deployed optimally in the public sector alone, would reduce cumulative TB incidence by 7.3% (95% credible intervals [CrI] 4.7-11) between 2020 and 2030, and by 16% (95% CrI 11-23) if also deployed in the private sector. This impact is roughly proportional to the effectiveness of the interventions. Reducing missed doses reduced incidence by 12% (95% CrI 7.0-18), while reducing treatment default reduced incidence by 7.9% (95% CrI 3.2-13).CONCLUSION:
Minimising missed doses is at least as important as promoting treatment completion. Our results suggest that emerging technologies to improve treatment adherence could have a substantial impact on TB incidence and mortality in India.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
3_ND
/
4_TD
Problema de saúde:
2_enfermedades_transmissibles
/
3_neglected_diseases
/
3_tuberculosis
/
4_tuberculosis
Assunto principal:
Tuberculose
Tipo de estudo:
Incidence_studies
/
Prognostic_studies
Limite:
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Reino Unido