Evidence map›Paper›PMID 25216828›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2014

Cost-effectiveness of the Three I's for HIV/TB and ART to prevent TB among people living with HIV.

S Gupta, T Abimbola, A Date, A B Suthar, R Bennett, N Sangrujee, R Granich

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03302299 (URBAN ARCH), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03302299 phase4completednot on this mapstarted 2017, after this paper: background citation

URBAN ARCH (3/5) Uganda Cohort TB Preventive Therapy for HIV-infected Alcohol Users in Uganda: an Evaluation of Safety Tolerability and Adherence

TypeinterventionalSponsorUniversity of California, San FranciscoRan2017 to 2021Enrolled302ConditionsTuberculosis, HIV/AIDS, Alcohol AbuseArmsIsoniazid 300 Mg ORAL TABLET, Pyridoxine 25 Mg Oral Tablet
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 4 countries.

S GuptaJoint United Nations Programme on HIV/AIDS, Geneva, Switzerland.
T AbimbolaUS Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
A DateUS Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
A B SutharSouth African Centre for Epidemiological Modelling and Analysis, University of Stellenbosch, Cape Town, South Africa.
R BennettIndependent Consultant, Huntingdon, UK.
N SangrujeeUS Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
R GranichJoint United Nations Programme on HIV/AIDS, Geneva, Switzerland.
Centers for Disease Control and Prevention · USJoint United Nations Programme on HIV/AIDS · CHActiv8rlives (United Kingdom) · GBStellenbosch University · ZA

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectiveTo evaluate the cost-effectiveness of the Three I's for HIV/TB (human immunodeficiency virus/tuberculosis): antiretroviral therapy (ART), intensified TB case finding (ICF), isoniazid preventive treatment (IPT), and TB infection control (IC).

methodsUsing a 3-year decision-analytic model, we estimated the cost-effectiveness of a base scenario (55% ART coverage at CD4 count ⩿350 cells/mm(3)) and 19 strategies that included one or more of the following: 1) 90% ART coverage, 2) IC and 3) ICF using four-symptom screening and 6- or 36-month IPT. The TB diagnostic algorithm included 1) sputum smear microscopy with chest X-ray, and 2) Xpert® MTB/RIF.

resultsIn resource-constrained settings with a high burden of HIV and TB, the most cost-effective strategies under both diagnostic algorithms included 1) 55% ART coverage and IC, 2) 55% ART coverage, IC and 36-month IPT, and 3) expanded ART at 90% coverage with IC and 36-month IPT. The latter averted more TB cases than other scenarios with increased ART coverage, IC, 6-month IPT and/or IPT for tuberculin skin test positive individuals. The cost-effectiveness results did not change significantly under the sensitivity analyses.

conclusionExpanded ART to 90% coverage, IC and a 36-month IPT strategy averted most TB cases and is among the cost-effective strategies.

Indexed as

Cost-Benefit AnalysisModels, EconomicAlgorithmsAntitubercular AgentsCD4 Lymphocyte CountDrug Resistance, BacterialHIV InfectionsHumansIsoniazidMycobacterium tuberculosisRadiographyRifampinSensitivity and SpecificityTuberculosisAntitubercular AgentsIsoniazidRifampin

Identifiers

PMID25216828
PMCPMC4886505
OpenAlexW2335528247

What OpenQuestion holds

Textmetadata
LicenceTDM
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.