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EXPLORING THE EPIDEMIOLOGICAL IMPACT OF UNIVERSAL ACCESS TO RAPID TUBERCULOSIS DIAGNOSIS USING AGENT-BASED SIMULATION
Cited 1 time in
Web of Science
Cited 1 time in Scopus
- Authors
- Issue Date
- 2017
- Publisher
- IEEE
- Citation
- 2017 WINTER SIMULATION CONFERENCE (WSC), pp.1097-1108
- Abstract
- Many high-burden countries have committed to providing universal access to rapid diagnosis of tuberculosis (TB), but the corresponding impact on population-wide incidence is unknown. We designed an agent-based simulation of drug-susceptible (DS) and drug-resistant (DR) TB in a representative Indian setting and compared the impact of Xpert testing via a decentralized (Xpert available at each local-population) versus centralized (Xpert available at the district-level serving multiple local-populations) strategy. Decentralized testing resulted in a 36% reduction in DR-TB incidence at 10 years compared to no Xpert. Depending on assumptions regarding pre-treatment loss to follow-up (ranging from 5 to 50%), the impact of centralized testing ranged from a 35% to 22% reduction in DR-TB incidence. Implementation of Xpert by either approach had a negligible impact (<5%) on DS-TB incidence. Decisions regarding choice of centralized vs. decentralized Xpert will heavily depend on operational aspects of centralized Xpert and loss to follow-up.
- ISSN
- 0891-7736
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