Strategic planning for tuberculosis control in the Republic of Fiji

Ragonnet, Romain, Underwood, Frank, Doan, Tan, Rafai, Eric, Trauer, James, and McBryde, Emma (2019) Strategic planning for tuberculosis control in the Republic of Fiji. Tropical Medicine and Infectious Disease, 4 (2). 71.

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The tuberculosis (TB) health burden in Fiji has been declining in recent years, although challenges remain in improving control of the diabetes co-epidemic and achieving adequate case detection across the widely dispersed archipelago. We applied a mathematical model of TB transmission to the TB epidemic in Fiji that captured the historical reality over several decades, including age stratification, diabetes, varying disease manifestations, and incorrect diagnoses. Next, we simulated six intervention scenarios that are under consideration by the Fiji National Tuberculosis Program. Our findings show that the interventions were able to achieve only modest improvements in disease burden, with awareness raising being the most effective intervention to reduce TB incidence, and treatment support yielding the highest impact on mortality. These improvements would fall far short of the ambitious targets that have been set by the country, and could easily be derailed by moderate increases in the diabetes burden. Furthermore, the effectiveness of the interventions was limited by the extensive pool of latent TB infection, because the programs were directed at only active cases, and thus were unlikely to achieve the desired reductions in burden. Therefore, it is essential to address the co-epidemic of diabetes and treat people with latent TB infection.

Item ID: 61839
Item Type: Article (Research - C1)
ISSN: 2414-6366
Keywords: disease modelling, epidemiology, health policy, public health, simulation, tuberculosis
Copyright Information: © 2019 by the authors.
Funders: Global Fund to Fight AIDS, Tuberculosis and Malaria, Department of Foreign Affairs and Trade of the Australian Government
Date Deposited: 25 May 2020 21:56
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 100%
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