Table 1 Parameters
From: Cost and cost-effectiveness of tuberculosis treatment shortening: a model-based analysis
Parameter, value [range] | South Africa | Brazil | Bangladesh | Tanzania | Reference |
|---|---|---|---|---|---|
Population distribution | |||||
Smear-positivity: HIV-negative, HIV-positive no ART, HIV-positive ART | 0.69, 0.35, 0.45 | ||||
MDR prevalence, among new patients | 1.8% | 1.4% | 1.4% | 1.1% | |
Prevalence of HIV in TB patients | 62% | 17% | 3% | 37% | |
Diagnosis of TB | |||||
TB diagnosis, sensitivity, smear, HIV negative | 0.72 [0.62–0.82] | ||||
TB diagnosis, sensitivity, smear, HIV positive | 0.47 [0.51–0.43] | ||||
TB diagnosis, sensitivity, GeneXpert, smear positive | 0.98 [0.97–0.99] | [36] | |||
TB diagnosis, sensitivity, GeneXpert, smear negative | 0.68 [0.59–0.75] | [36] | |||
TB diagnosis, specificity, GeneXpert, all | 0.98 [0.97–0.99] | [36] | |||
TB diagnosis, specificity, smear, all | 1 | assumption | |||
RIF-resistance diagnosis, sensitivity, GeneXpert, all | 0.94 [0.87–0.97] | [36] | |||
RIF-resistance diagnosis, specificity, GeneXpert, all | 0.98 [0.97–0.99] | [36] | |||
Outcomes (first line treatment) | |||||
Pr mortality: | |||||
Pan-sensitive, HIV negative | 0.03 [0.02–0.03] | [37] | |||
MDR, HIV negative | 0.11 [0.08–0.13] | [37] | |||
Pan-sensitive, HIV positive, ART | 0.07 [0.05–0.09] | [38] | |||
Pan-sensitive, HIV positive, no ART | 0.33 [0.30–0.43] | [38] | |||
MDR, HIV positive, ART | 0.11 [0.10–0.21] | ||||
MDR, HIV positive, no ART | 0.85 [0.72–0.98] | [39] | |||
Pr cure, if treatment completed: | |||||
Pan-sensitive | 0.97 [0.95–0.98] | [13] | |||
MDR | 0.50 [0.40–0.55] | [37] | |||
Pr cure, if less than 2 months treatment completed | |||||
HIV negative, smear negative | 0.20 [0.15–0.25] | ||||
HIV negative, smear positive | 0.30 [0.20–0.40] | ||||
HIV positive, smear neg/pos, no ART | 0 [0–0.05] | ||||
HIV positive, smear negative, ART | 0.10 [0.05–0.15] | ||||
HIV positive, smear positive, ART | 0.05 [0–0.10] | ||||
Pr cure, if default at (standard 6mo regimen): | |||||
2–3 months, pan-sensitive | 0.68 [0.50–0.80] | [43] | |||
2–3 months, MDR | 0.35 [0.21–0.45] | [43] | |||
4–5 months, pan-sensitive | 0.86 [0.70–0.89] | ||||
4–5 months, MDR | 0.48 [0.29–0.51] | ||||
Pr cure, if default at (new 4mo regimen): | |||||
2–3 months, pan-sensitive | 0.74 [0.57–0.83] | Assumption | |||
2–3 months, MDR | 0.38 [0.23–0.47] | Assumption | |||
Outcomes (second round of treatment) | |||||
Pr patients returning to care after default | 0.21 [0.10–0.70] | [46] | |||
Pr patients staying in care after failure | 0.60 [0.40–0.80] | Assumption | |||
Pr mortality | |||||
HIV negative/positive ART, pan-sensitive | 0.06 [0.04–0.07] | [37] | |||
HIV negative/positive ART, MDR | 0.15 [0.10–0.20] | [37] | |||
HIV positive no ART, pan-sensitive | 0.33 [0.30–0.43] | [38] | |||
HIV positive no ART, MDR | 0.85 [0.72–0.98] | [39] | |||
MDR treatment and long term outcomes | |||||
Pr cure, MDR treatment (including default) | 0.65–0.80 | [47] | |||
Mortality during MDR treatment | 0.10 | [48] | |||
Pr long term mortality (chronic TB patient or default patient if no return to care) | 0.75 [0.50–0.99] | [48] | |||
Self-cure among chronic TB patients | 0.01 | [48] | |||
DALYs averted (discounted at 0.03/year) | |||||
HIV negative, smear negative | 12.5 [11.3–13.8] | 19.3 [17.4–21.3] | 15.3 [13.7–16.8] | 14.2 [12.8–15.7] | Additional file 1 |
HIV negative, smear positive | 15.2 [13.7–16.7] | 22.0 [19.8–24.2] | 17.9 [16.1–19.7] | 16.9 [15.2–18.6] | Additional file 1 |
HIV positive, smear negative, no ART | 1.8 [1.6–2.0] | 1.8 [1.6–2.0] | 1.8 [1.6–2.0] | 1.8 [1.6–2.0] | Additional file 1 |
HIV positive, smear positive, no ART | 2.0 [1.8–2.2] | 2.0 [1.8–2.2] | 2.0 [1.8–2.2] | 2.0 [1.8–2.2] | Additional file 1 |
HIV positive, smear negative, ART | 9.9 [8.9–10.9] | 9.9 [8.9–10.9] | 9.9 [8.9–10.9] | 9.9 [8.9–10.9] | Additional file 1 |
HIV positive, smear positive, ART | 10.1 [9.1–11.1] | 10.1 [9.1–11.1] | 10.1 [9.1–11.1] | 10.1 [9.1–11.1] | Additional file 1 |