9/12/2023 0 Comments Negative tb test results![]() All industry partnerships are subject to review by an independent Scientific Advisory Committee or another independent review body, based on due diligence, TPPs and public sector requirements. It has organisational firewalls to protect it against any undue influences in its work or the publication of its findings. It works closely with the private and public sectors and receives funding from some of its industry partners. FIND is a non-for-profit foundation, whose mission is to find diagnostic solutions to overcome diseases of poverty in LMICs. CMD is on the editorial board of PLOS Medicine. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: SR, TBH and NA have declared that no competing interests exist. NA and TBH were supported by grant number MR/R015600/1, jointly funded by the UK Medical Research Council (MRC) and the UK Department for International Development (DFID). įunding: SR was supported by grant number 203839/A/16/Z, funded by the Wellcome Trust. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the manuscript and its Supporting Information files. Received: MaAccepted: NovemPublished: December 11, 2020Ĭopyright: © 2020 Ricks et al. PLoS Med 17(12):Īcademic Editor: Amitabh Bipin Suthar, Centers for Disease Control, UNITED STATES ![]() Our model neglects drug resistance and focuses on the country-level epidemic, thus ignoring subnational variations in HIV and TB burden.Ĭitation: Ricks S, Denkinger CM, Schumacher SG, Hallett TB, Arinaminpathy N (2020) The potential impact of urine-LAM diagnostics on tuberculosis incidence and mortality: A modelling analysis. Amongst limitations of this analysis, we do not address the cost or cost-effectiveness of future tests. Sensitivity analysis demonstrates qualitatively similar results in a setting like Kenya, which also has a generalised HIV epidemic, but a lower burden of HIV/TB coinfection. Qualitatively similar results apply under an alternative comparator assuming expanded use of GeneXpert MTB/RIF (‘Xpert’) for TB diagnosis. Notably, this increase in impact arises largely from diagnosis of TB amongst those with HIV who are not yet in HIV care, and who would thus be ineligible for a LAM test under current guidelines. Similar patterns apply to incidence results. This impact in absolute deaths averted doubles if testing is expanded to include outpatients, yet remains <1% of country-level TB deaths. Relative to this comparator, current and future LAM tests would respectively avert 54 (95% CrI 33–86) and 90 (95% CrI 55–145) TB deaths amongst inpatients between 20, i.e., reductions of 5% (95% CrI 4%–6%) and 9% (95% CrI 7%–11%) in inpatient TB mortality. Our model projects that 2,700,000 (95% credible interval 2,000,000–3,600,000) and 420,000 (95% CrI 350,000–520,000) cumulative TB incident cases and deaths, respectively, would occur between 20 if the status quo is maintained. We also simulated the hypothetical deployment of future LAM tests for all people presenting to care with TB symptoms, not restricted to PLHIV. We modelled the impact of both tests, assuming full adoption of the 2019 WHO guidelines for the use of these tests amongst those receiving HIV care. We developed a mathematical model of TB transmission to project the impact of LAM tests, distinguishing ‘current’ tests (with sensitivity consistent with LF-LAM), from hypothetical ‘future’ tests (having sensitivity consistent with SILVAMP-LAM). Concentrating on South Africa, we examined the impact that widening LAM test eligibility would have on TB incidence and mortality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |