Assessing the impacts of short-course multidrug-resistant tuberculosis treatment in the Southeast Asia Region using a mathematical modeling approach
This study aimed to predict the impacts of shorter duration treatment regimens for multidrug-resistant tuberculosis (MDR-TB) on both MDR-TB percentage among new cases and overall MDR-TB cases in the WHO Southeast Asia Region. A deterministic compartmental model was constructed to describe both the t...
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| description | This study aimed to predict the impacts of shorter duration treatment regimens for multidrug-resistant tuberculosis (MDR-TB) on both MDR-TB percentage among new cases and overall MDR-TB cases in the WHO Southeast Asia Region. A deterministic compartmental model was constructed to describe both the transmission of TB and the MDR-TB situation in the Southeast Asia region. The population-level impacts of short-course treatment regimens were compared with the impacts of conventional regimens. Multi-way analysis was used to evaluate the impact by varying programmatic factors (eligibility for short-course MDR-TB treatment, treatment initiation, and drug susceptibility test (DST) coverage). The model predicted that overall TB incidence will be reduced from 246 (95% credible intervals (CrI), 221-275) per 100,000 population in 2020 to 239 (95% CrI, 215-267) per 100,000 population in 2035, with a modest reduction of 2.8% (95% CrI, 2.7%-2.9%). Despite the slight reduction in overall TB infections, the model predicted that the MDR-TB percentage among newly notified TB infections will remain steady, with 2.4% (95% CrI, 2.1-2.9) in 2020 and 2.5% (95% CrI, 2.3-3.1) in 2035, using conventional MDR-TB treatment. With the introduction of short-course regimens to treat MDR-TB, the development of resistance can be slowed by 38.6% (95% confidence intervals (CI), 35.9-41.3) reduction in MDR-TB case number, and 37.6% (95% CI, 34.9-40.3) reduction in MDR-TB percentage among new TB infections over the 30-year period compared with the baseline using the standard treatment regimen. The multi-way analysis showed eligibility for short-course treatment and treatment initiation greatly influenced the impacts of short-course treatment regimens on reductions in MDR-TB cases and percentage resistance among new infections. Policies which promote the expansion of short-course regimens and early MDR-TB treatment initiation should be considered along with other interventions to tackle antimicrobial resistance in the region. |
| doi_str_mv | 10.1371/journal.pone.0248846 |
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A deterministic compartmental model was constructed to describe both the transmission of TB and the MDR-TB situation in the Southeast Asia region. The population-level impacts of short-course treatment regimens were compared with the impacts of conventional regimens. Multi-way analysis was used to evaluate the impact by varying programmatic factors (eligibility for short-course MDR-TB treatment, treatment initiation, and drug susceptibility test (DST) coverage). The model predicted that overall TB incidence will be reduced from 246 (95% credible intervals (CrI), 221-275) per 100,000 population in 2020 to 239 (95% CrI, 215-267) per 100,000 population in 2035, with a modest reduction of 2.8% (95% CrI, 2.7%-2.9%). Despite the slight reduction in overall TB infections, the model predicted that the MDR-TB percentage among newly notified TB infections will remain steady, with 2.4% (95% CrI, 2.1-2.9) in 2020 and 2.5% (95% CrI, 2.3-3.1) in 2035, using conventional MDR-TB treatment. With the introduction of short-course regimens to treat MDR-TB, the development of resistance can be slowed by 38.6% (95% confidence intervals (CI), 35.9-41.3) reduction in MDR-TB case number, and 37.6% (95% CI, 34.9-40.3) reduction in MDR-TB percentage among new TB infections over the 30-year period compared with the baseline using the standard treatment regimen. The multi-way analysis showed eligibility for short-course treatment and treatment initiation greatly influenced the impacts of short-course treatment regimens on reductions in MDR-TB cases and percentage resistance among new infections. Policies which promote the expansion of short-course regimens and early MDR-TB treatment initiation should be considered along with other interventions to tackle antimicrobial resistance in the region.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0248846</identifier><identifier>PMID: 33770104</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Bayesian analysis ; Biology and Life Sciences ; Care and treatment ; Data analysis ; Disease ; Disease transmission ; Drug resistance ; Economic models ; Editing ; Health risks ; HIV ; Human immunodeficiency virus ; Hygiene ; Infections ; Markov chains ; Mathematical models ; Medical science ; Medicine ; Medicine and Health Sciences ; Methodology ; Monte Carlo simulation ; Multidrug resistance ; Multidrug resistant organisms ; Ordinary differential equations ; Parameter estimation ; People and Places ; Pharmacology ; Physical Sciences ; Population ; Public health ; Research facilities ; Rifampin ; Tuberculosis ; Visualization</subject><ispartof>PloS one, 2021-03, Vol.16 (3), p.e0248846-e0248846</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Han et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Han et al 2021 Han et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-5ac8a1960e853ff9dfb1142323990964266e48496c1fe53ab110d599b508c84a3</citedby><cites>FETCH-LOGICAL-c692t-5ac8a1960e853ff9dfb1142323990964266e48496c1fe53ab110d599b508c84a3</cites><orcidid>0000-0003-3731-7960 ; 0000-0002-9839-5359</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997007/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997007/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33770104$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Smith, Rebecca Lee</contributor><creatorcontrib>Han, Win Min</creatorcontrib><creatorcontrib>Mahikul, Wiriya</creatorcontrib><creatorcontrib>Pouplin, Thomas</creatorcontrib><creatorcontrib>Lawpoolsri, Saranath</creatorcontrib><creatorcontrib>White, Lisa J</creatorcontrib><creatorcontrib>Pan-Ngum, Wirichada</creatorcontrib><title>Assessing the impacts of short-course multidrug-resistant tuberculosis treatment in the Southeast Asia Region using a mathematical modeling approach</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>This study aimed to predict the impacts of shorter duration treatment regimens for multidrug-resistant tuberculosis (MDR-TB) on both MDR-TB percentage among new cases and overall MDR-TB cases in the WHO Southeast Asia Region. 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With the introduction of short-course regimens to treat MDR-TB, the development of resistance can be slowed by 38.6% (95% confidence intervals (CI), 35.9-41.3) reduction in MDR-TB case number, and 37.6% (95% CI, 34.9-40.3) reduction in MDR-TB percentage among new TB infections over the 30-year period compared with the baseline using the standard treatment regimen. The multi-way analysis showed eligibility for short-course treatment and treatment initiation greatly influenced the impacts of short-course treatment regimens on reductions in MDR-TB cases and percentage resistance among new infections. Policies which promote the expansion of short-course regimens and early MDR-TB treatment initiation should be considered along with other interventions to tackle antimicrobial resistance in the region.</description><subject>Bayesian analysis</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Data analysis</subject><subject>Disease</subject><subject>Disease transmission</subject><subject>Drug resistance</subject><subject>Economic models</subject><subject>Editing</subject><subject>Health risks</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Hygiene</subject><subject>Infections</subject><subject>Markov chains</subject><subject>Mathematical models</subject><subject>Medical science</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Methodology</subject><subject>Monte Carlo simulation</subject><subject>Multidrug resistance</subject><subject>Multidrug resistant 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One</addtitle><date>2021-03-26</date><risdate>2021</risdate><volume>16</volume><issue>3</issue><spage>e0248846</spage><epage>e0248846</epage><pages>e0248846-e0248846</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>This study aimed to predict the impacts of shorter duration treatment regimens for multidrug-resistant tuberculosis (MDR-TB) on both MDR-TB percentage among new cases and overall MDR-TB cases in the WHO Southeast Asia Region. A deterministic compartmental model was constructed to describe both the transmission of TB and the MDR-TB situation in the Southeast Asia region. The population-level impacts of short-course treatment regimens were compared with the impacts of conventional regimens. Multi-way analysis was used to evaluate the impact by varying programmatic factors (eligibility for short-course MDR-TB treatment, treatment initiation, and drug susceptibility test (DST) coverage). The model predicted that overall TB incidence will be reduced from 246 (95% credible intervals (CrI), 221-275) per 100,000 population in 2020 to 239 (95% CrI, 215-267) per 100,000 population in 2035, with a modest reduction of 2.8% (95% CrI, 2.7%-2.9%). Despite the slight reduction in overall TB infections, the model predicted that the MDR-TB percentage among newly notified TB infections will remain steady, with 2.4% (95% CrI, 2.1-2.9) in 2020 and 2.5% (95% CrI, 2.3-3.1) in 2035, using conventional MDR-TB treatment. With the introduction of short-course regimens to treat MDR-TB, the development of resistance can be slowed by 38.6% (95% confidence intervals (CI), 35.9-41.3) reduction in MDR-TB case number, and 37.6% (95% CI, 34.9-40.3) reduction in MDR-TB percentage among new TB infections over the 30-year period compared with the baseline using the standard treatment regimen. The multi-way analysis showed eligibility for short-course treatment and treatment initiation greatly influenced the impacts of short-course treatment regimens on reductions in MDR-TB cases and percentage resistance among new infections. Policies which promote the expansion of short-course regimens and early MDR-TB treatment initiation should be considered along with other interventions to tackle antimicrobial resistance in the region.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33770104</pmid><doi>10.1371/journal.pone.0248846</doi><tpages>e0248846</tpages><orcidid>https://orcid.org/0000-0003-3731-7960</orcidid><orcidid>https://orcid.org/0000-0002-9839-5359</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Bayesian analysis Biology and Life Sciences Care and treatment Data analysis Disease Disease transmission Drug resistance Economic models Editing Health risks HIV Human immunodeficiency virus Hygiene Infections Markov chains Mathematical models Medical science Medicine Medicine and Health Sciences Methodology Monte Carlo simulation Multidrug resistance Multidrug resistant organisms Ordinary differential equations Parameter estimation People and Places Pharmacology Physical Sciences Population Public health Research facilities Rifampin Tuberculosis Visualization |
| title | Assessing the impacts of short-course multidrug-resistant tuberculosis treatment in the Southeast Asia Region using a mathematical modeling approach |
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