Scenario Analysis for Programmatic Tuberculosis Control in Western Province, Papua New Guinea

摘要: Tuberculosis (TB) and multidrug-resistant TB (MDR-TB) are major health problems in Western Province, Papua New Guinea. While comprehensive expansion of control programs is desirable, logistical challenges considerable, there substantial uncertainty regarding the true disease burden. We parameterized our previously described mathematical model Mycobacterium tuberculosis dynamics following an epidemiologic assessment. Five hypothetical scenarios representing alternative programmatic approaches during period from 2013 to 2023 were developed with local staff. Bayesian analyses undertaken explicitly acknowledge around key parameters, economic evaluation was performed. With continuation existing strategies, overall incidence remained stable at 555 cases per 100,000 population year (95% simulation interval (SI): 420, 807), but proportion incident attributable MDR-TB increased 16% 35%. Comprehensive, provincewide strengthening reduced 353 SI: 246, 558), 46% being MDR-TB, while incorporating management into these 233 198, 269) 14% MDR-TB. Most costs due hospitalization intensive treatment phase. Broad scale-up activities Province incorporation vital if be achieved. Community-based important reduce associated costs.