ArticleBMC medicine2021
Achieving a "step change" in the tuberculosis epidemic through comprehensive community-wide intervention: a model-based analysis.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- The epidemiological impact, costs, and cost-effectiveness of implementing household contact investigation with tuberculosis preventive treatment in Nepal: a model-based analysis.BMC global and public health · 2026Article
- Modeling the Impact of Case Finding for Tuberculosis: The Role of Infection Dynamics.The Journal of infectious diseases · 2026Article
- Combination interventions to control the tuberculosis epidemic in the Karamoja subregion of Uganda: A modelling analysis.PLOS global public health · 2026Article
- The health impact of identifying a person with tuberculosis through systematic screening.The Lancet. Infectious diseases · 2025Review
- What Is the Optimal Community-Based Tuberculosis Screening Algorithm for People Who Inject Drugs in a High-Burden Setting?Open forum infectious diseases · 2025Article
- Ensuring Continuity of Tuberculosis Care during Social Distancing through Integrated Active Case Finding at COVID-19 Vaccination Events in Vietnam: A Cohort Study.Tropical medicine and infectious disease · 2024Article
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- Tuberculosis care models for children and adolescents: a scoping review.Bulletin of the World Health Organization · 2022Article
- Variance-based sensitivity analysis of tuberculosis transmission models.Journal of the Royal Society, Interface · 2022Article
- Costs incurred by patients with tuberculosis co-infected with human immunodeficiency virus in Bhavnagar, western India: a sequential explanatory mixed-methods research.BMC health services research · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundGlobal progress towards reducing tuberculosis (TB) incidence and mortality has consistently lagged behind the World Health Organization targets leading to a perception that large reductions in TB burden cannot be achieved. However, several recent and historical trials suggest that intervention efforts that are comprehensive and intensive can have a substantial epidemiological impact. We aimed to quantify the potential epidemiological impact of an intensive but realistic, community-wide campaign utilizing existing tools and designed to achieve a "step change" in the TB burden.
methodsWe developed a compartmental model that resembled TB transmission and epidemiology of a mid-sized city in India, the country with the greatest absolute TB burden worldwide. We modeled the impact of a one-time, community-wide screening campaign, with treatment for TB disease and preventive therapy for latent TB infection (LTBI). This one-time intervention was followed by the strengthening of the tuberculosis-related health system, potentially facilitated by leveraging the one-time campaign. We estimated the tuberculosis cases and deaths that could be averted over 10 years using this comprehensive approach and assessed the contributions of individual components of the intervention.
resultsA campaign that successfully screened 70% of the adult population for active and latent tuberculosis and subsequently reduced diagnostic and treatment delays and unsuccessful treatment outcomes by 50% was projected to avert 7800 (95% range 5450-10,200) cases and 1710 (1290-2180) tuberculosis-related deaths per 1 million population over 10 years. Of the total averted deaths, 33.5% (28.2-38.3) were attributable to the inclusion of preventive therapy and 52.9% (48.4-56.9) to health system strengthening.
conclusionsA one-time, community-wide mass campaign, comprehensively designed to detect, treat, and prevent tuberculosis with currently existing tools can have a meaningful and long-lasting epidemiological impact. Successful treatment of LTBI is critical to achieving this result. Health system strengthening is essential to any effort to transform the TB response.
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