A model for the epidemiological impact of tuberculosis policy options.

Abstract

Objective: To develop a new tuberculosis transmission model, addressing the limitations of and building on the TB Impact Model and Estimates software tool, to enable decision-makers to assess the impact of various tuberculosis interventions and allocate resources more effectively. Methods: We designed a model incorporating diagnosis and treatment pathways across public and private sectors, stratified across age groups, drug susceptibility, human immunodeficiency virus status and vaccination status. We calibrated our model using country-specific data from 29 high-burden countries and determined calibration target indicators according to national epidemic profiles. We performed the model calibration using a Bayesian adaptive Markov chain Monte Carlo process. We compare modelled and actual data for Indonesia and Nigeria. Findings: could reduce tuberculosis incidence by 27% and mortality by 37% by 2030, even without a vaccine. Conclusion: Our model provides a robust analytical foundation from which to assess the epidemiological impact of diverse interventions, prioritize investments and guide policy. The model's open-source design and alignment with WHO recommendations make it a valuable tool for guiding evidence-based investment.