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Home / The International Journal of Tuberculosis and Lung Disease, Volume 18, Number 5

How can mathematical models advance tuberculosis control in high HIV prevalence settings?

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Existing approaches to tuberculosis (TB) control have been no more than partially successful in areas with high human immunodeficiency virus (HIV) prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing those strategies that are most likely to bring public health and economic benefits. In this paper, we present an overview of past and recent contributions of TB modelling in this key area, and suggest a way forward through a modelling research agenda that supports a more effective response to the TB-HIV epidemic, based on expert discussions at a meeting convened by the TB Modelling and Analysis Consortium. The research agenda identified high-priority areas for future modelling efforts, including 1) the difficult diagnosis and high mortality of TB-HIV; 2) the high risk of disease progression; 3) TB health systems in high HIV prevalence settings; 4) uncertainty in the natural progression of TB-HIV; and 5) combined interventions for TB-HIV. Efficient and rapid progress towards completion of this modelling agenda will require co-ordination between the modelling community and key stakeholders, including advocates, health policy makers, donors and national or regional finance officials. A continuing dialogue will ensure that new results are effectively communicated and new policy-relevant questions are addressed swiftly.

Keywords: HIV; mathematical modelling; sub-Saharan Africa; systematic literature review; tuberculosis

Document Type: Research Article

Affiliations: 1: TB Modelling Group, TB Centre, and Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine (LSHTM), London, UK 2: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA 3: Department of Global Health and Development, LSHTM, London, UK 4: Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA 5: Division of Medical Microbiology and Institute of Infectious Diseases and Molecular Medicine, University of Cape Town and National Health Laboratory Service, South Africa 6: Joint United Nations Programme on HIV/AIDS, World Health Organization (WHO), Geneva, Switzerland 7: Oxford-Emergent Tuberculosis Consortium, Wokingham, UK 8: Intellectual Ventures Laboratory, Bellevue, Washington, USA 9: HIV, TB Malaria and Neglected Tropical Diseases Cluster, WHO, Geneva, Switzerland 10: Bill and Melinda Gates Foundation, Seattle, Washington, USA

Publication date: 01 May 2014

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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