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Modelling the potential impact of adherence technologies on tuberculosis in India
N Arinaminpathy1, D P Chin2, K S Sachdeva3
1Imperial College London, UK.
Summary
Minimizing missed tuberculosis (TB) doses is crucial for preventing relapse and reducing TB incidence in India. New adherence technologies show significant potential to lower TB cases when implemented effectively.
Area of Science:
- Public Health
- Epidemiology
- Health Technology
Background:
- Missing 10% or more of first-line tuberculosis (TB) treatment doses significantly elevates relapse risk six-fold.
- Digital technologies present novel strategies for enhancing TB patient adherence.
- The study assesses the potential impact of these new adherence technologies within India.
Purpose of the Study:
- To estimate the potential impact of new adherence technologies on tuberculosis transmission dynamics in India.
- To evaluate the combined effects of interventions targeting missed doses and treatment default.
Main Methods:
- A mathematical model simulating TB transmission in India was developed.
- The model independently accounted for missed doses and treatment default effects on recurrence.
- Simulations assessed interventions across public and private healthcare sectors.
Main Results:
- Optimal adherence interventions in the public sector could decrease cumulative TB incidence by 7.3% (2020-2030).
- Including the private sector could boost the reduction to 16%.
- Reducing missed doses showed a greater impact (12% incidence reduction) than reducing treatment default (7.9% incidence reduction).
Conclusions:
- Minimizing missed doses is as critical as ensuring treatment completion for TB control.
- Emerging adherence technologies hold substantial promise for reducing TB incidence and mortality in India.
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