Kubjane, Mmamapudi ORCID: 0000-0003-1873-198X, Osman, Muhammad ORCID: 0000-0003-3818-9729, Boulle, Andrew and Johnson, Leigh F. ORCID: 0000-0002-2717-011X (2022) The impact of HIV and tuberculosis interventions on South African adult tuberculosis trends, 1990-2019: a mathematical modelling analysis. International Journal of Infectious Diseases, 122. pp. 811-819. ISSN 1201-9712 (doi:https://doi.org/10.1016/j.ijid.2022.07.047)

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Abstract

Objectives: To quantify the South African adult tuberculosis (TB) incidence and mortality attributable to HIV between 1990 and 2019 and to estimate the reduction in TB incidence due to directly observed therapy, antiretroviral therapy (ART), isoniazid preventive therapy, increased TB screening, and Xpert MTB/RIF.
Methods: We developed a dynamic TB transmission model for South Africa. A Bayesian approach was used to calibrate the model to South African-specific data sources. Counterfactual scenarios were simulated to estimate TB incidence and mortality attributable to HIV and the impact of interventions on TB
incidence.
Results: Between 1990 and 2019, 8.8 million (95% confidence interval [CI] 8.3-9.3 million) individuals developed TB, and 2.1 million (95% CI 2.0-2.2 million) died from TB. A total of 55% and 69% of TB cases and
mortality were due to HIV, respectively. Overall, TB screening and ART substantially reduced TB incidence by 28.2% (95% CI 26.4-29.8%) and 20.0% (95% CI 19.2-20.7%), respectively, in 2019; other interventions had
minor impacts.
Conclusion: HIV has dramatically increased TB incidence and mortality in South Africa. The provision of ART and intensification of TB screening explained most recent declines in TB incidence.

Item Type:	Article
Uncontrolled Keywords:	Tuberculosis, HIV, mathematical modelling
Subjects:	Q Science > Q Science (General)
Faculty / School / Research Centre / Research Group:	Faculty of Education, Health & Human Sciences Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development Faculty of Education, Health & Human Sciences > Institute for Lifecourse Development > Centre for Vulnerable Children and Families
Last Modified:	24 Aug 2022 09:10
URI:	http://gala.gre.ac.uk/id/eprint/37070

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