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Background: The disease burden of active tuberculosis (TB) is considerable, but systematic reviews of economic evaluations of active TB treatments are scarce.Methods: PubMed, EMBASE, and the Cochrane Library databases were used to search for articles on cost-effectiveness analysis or cost-utility analysis that economically evaluated active TB treatments, which were then systematically reviewed by two independent reviewers. We extracted vital components of the included studies, such as country, population, intervention/comparator, primary outcome, values of outcomes, thresholds, model type, time horizon, and health states included in the model.Results: Seventeen studies were included in this systematic review. Thirteen dealt with interventions of medications, and the remaining four compared care strategies. The Markov model was the most commonly used tool to compare medications, whereas studies on care plans mainly used decision trees. The most commonly used primary outcome was disability-adjusted life years, followed by quality-adjusted life years. For treatment-naïve TB, the 4-month regimen was more cost-effective than the 6-month regimen mainly in low- and middle-income countries. For multidrug-resistant TB, a bedaquiline-based regimen was cost-effective. For multidrug-resistant TB, decentralized care that employed the use of home or mobile devices was more cost-effective than hospital-based centralized care in low- and middle-income countries.Conclusion: New treatment strategies to improve therapeutic outcomes by enhancing treatment adherence, such as regimens with shorter durations (2 or 4 months) and decentralized care, or new anti-TB agents (e.g., bedaquiline) have been suggested as cost-effective interventions for active TB. This review provides information on the economic evaluation of active TB from good-quality studies, thus aiding the future economic evaluation of active TB.

The Spectral Ocean Wave Model (SOWM) is a numerical wave prediction model which calculates directional wave spectra from input wind fields. As do the majority of wave models, it uses a point spectral growth mechanism, i.e., it applies the energy balance equation in a directionally integrated form. The directionality of its growth is obtained from an assumed spreading function on the wind direction. In this study, the energy balance equation is applied in directional form using directional atmospheric energy source functions. The B function of Miles’ instability mechanism is derived following the analysis of Phillips and it is tuned to the directionally integrated form used in the SOWM. Two infinite ocean wave models are used to compare the behavior of the point and directional growth mechanisms under various wind conditions. The directional form shows more flexibility in responding to directionally varying winds while the point spectral form creates excess energy spread widely over direction when operating in the presence of swell. Ph. D. incomplete_metadata