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• W2885679075 abstract "Background: We model the epidemiological impact of providing isoniazid preventive therapy (IPT) to South African adolescents, among whom HIV prevalence is low, latent tuberculosis (TB) prevalence is high, and school-based programs may enable population-level coverage. Methods: We simulate a dynamic compartmental model of age-structured HIV and TB coepidemics in South Africa. HIV dynamics are modeled by infection status, CD4+ cell count, and antiretroviral therapy; TB dynamics are modeled by disease stage, diagnosis, treatment, and IPT status. We analyze the effects of continuous IPT coverage among adolescents from 5 (baseline) to 90%. Results: Our model is calibrated to WHO and the Joint United Nations Programme on HIV/AIDS epidemiological estimates. In simulations, increasing IPT coverage to 50% among adolescents reduced active TB incidence by 5–34%. Increasing coverage to 90% led to a 9–40% reduction in active TB incidence. Expanded IPT access causes TB incidence to decline in the general population of HIV-positive individuals, as well as in adult HIV-positive individuals. Conclusion: Targeting IPT to a secondary school population with high latent TB prevalence and low-HIV prevalence, in which risk of false-negative diagnosis of active TB is low and IPT benefits are more established, could have substantial benefits to adolescents and spillover benefits to the adult population." @default.
• W2885679075 created "2018-08-22" @default.
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• W2885679075 date "2018-09-24" @default.
• W2885679075 modified "2023-09-25" @default.
• W2885679075 title "Modeling the implementation of population-level isoniazid preventive therapy for tuberculosis control in a high HIV-prevalence setting" @default.
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• W2885679075 doi "https://doi.org/10.1097/qad.0000000000001959" @default.
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