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Start Over Author "Roberts, D. Allen" Topic cost-effectiveness
4 results on '"Roberts, D. Allen"'

1. Preventing tuberculosis with community‐based care in an HIV‐endemic setting: a modelling analysis.

Author

Ross, Jennifer M., Greene, Chelsea, Broshkevitch, Cara J., Dowdy, David W., van Heerden, Alastair, Heitner, Jesse, Rao, Darcy W., Roberts, D. Allen, Shapiro, Adrienne E., Zabinsky, Zelda B., and Barnabas, Ruanne V.

Subjects
HIV infection transmission, SCIENTIFIC literature, TUBERCULOSIS, HIV-positive persons
Abstract

Introduction: Antiretroviral therapy (ART) and tuberculosis preventive treatment (TPT) both prevent tuberculosis (TB) disease and deaths among people living with HIV. Differentiated care models, including community‐based care, can increase the uptake of ART and TPT to prevent TB in settings with a high burden of HIV‐associated TB, particularly among men. Methods: We developed a gender‐stratified dynamic model of TB and HIV transmission and disease progression among 100,000 adults ages 15−59 in KwaZulu‐Natal, South Africa. We drew model parameters from a community‐based ART initiation and resupply trial in sub‐Saharan Africa (Delivery Optimization for Antiretroviral Therapy, DO ART) and other scientific literature. We simulated the impacts of community‐based ART and TPT care programmes during 2018−2027, assuming that community‐based ART and TPT care were scaled up to similar levels as in the DO ART trial (i.e. ART coverage increasing from 49% to 82% among men and from 69% to 83% among women) and sustained for 10 years. We projected the number of TB cases, deaths and disability‐adjusted life years (DALYs) averted relative to standard, clinic‐based care. We calculated programme costs and incremental cost‐effectiveness ratios from the provider perspective. Results: If community‐based ART care could be implemented with similar effectiveness to the DO ART trial, increased ART coverage could reduce TB incidence by 27.0% (range 21.3%−34.1%) and TB mortality by 34.6% (range 24.8%–42.2%) after 10 years. Increasing both ART and TPT uptake through community‐based ART with TPT care could reduce TB incidence by 29.7% (range 23.9%−36.0%) and TB mortality by 36.0% (range 26.9%−43.8%). Community‐based ART with TPT care reduced gender disparities in TB mortality rates, with a projected 54 more deaths annually among men than women (range 11–103) after 10 years of community‐based care versus 109 (range 41–182) in standard care. Over 10 years, the mean cost per DALY averted by community‐based ART with TPT care was $846 USD (range $709–$1012). Conclusions: By substantially increasing coverage of ART and TPT, community‐based care for people living with HIV could reduce TB incidence and mortality in settings with high burdens of HIV‐associated TB and reduce TB gender disparities. [ABSTRACT FROM AUTHOR]

Published
2024
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2. The impact of prevention‐effective PrEP use on HIV incidence: a mathematical modelling study.

Author

Roberts, D. Allen, Bridenbecker, Daniel, Haberer, Jessica E., Barnabas, Ruanne V., and Akullian, Adam

Subjects
*HIV, *PRE-exposure prophylaxis, *MATHEMATICAL models, *HIV status, *HIV prevention, *HIV seroconversion
Abstract

Introduction: Models that project the impact and cost‐effectiveness of HIV pre‐exposure prophylaxis (PrEP) must specify how PrEP use aligns with HIV exposure. We hypothesized that varying PrEP use according to individual‐level partnership dynamics rather than prioritization to population subgroups based on average risk will result in larger incidence reductions and greater efficiency. Methods: We used an individual‐based network transmission model calibrated to HIV dynamics in Eswatini to simulate PrEP use among individuals ages 15–34 between 2022 and 2031 under two paradigms of PrEP delivery: "Risk Group" and "Partnership." In the "Risk Group" paradigm, we varied PrEP coverage by risk groups (low, medium and high) defined by average partnership frequency and concurrency. In the "Partnership" paradigm, all individuals are potentially eligible for PrEP, but we assumed use occurs only during partnerships and varied prioritization by partner HIV status (no prioritization to high prioritization with HIV‐positive partners). We calculated person‐time on PrEP and incidence relative to a no PrEP scenario and estimated efficiency as the person‐years of PrEP needed to avert one additional infection (NNT). Results: In the Risk Group paradigm, restricting PrEP to the high‐risk group was the most efficient (NNT = 17), but the number of infections averted was limited by the small size of the high‐risk group. Expanding PrEP use to all risk groups averted up to three times more infections but with lower efficiency (NNT = 202). PrEP use under the Partnership paradigm was 2–6 times more efficient (NNT = 33–102) than the Risk Group paradigm with all groups eligible for PrEP. A 33% reduction in incidence among 15‐ to 34‐year‐olds was achieved at 46% (95% CI: 39–52%) PrEP coverage in the Risk Group paradigm and 6% (95% CI: 5–7%) to 17% (95% CI: 14–20%) in the Partnership paradigm. Conclusions: Modelling PrEP use based on risk groups resulted in a sharp trade‐off between PrEP efficiency and impact, whereas PrEP use predicated on partnerships resulted in much higher efficiency for widespread PrEP availability. Model estimates of PrEP impact and cost‐effectiveness in generalized epidemics are strongly influenced by assumptions about how PrEP use aligns with individual‐level HIV exposure heterogeneity. [ABSTRACT FROM AUTHOR]

Published
2022
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3. The role of costing in the introduction and scale‐up of HIV pre‐exposure prophylaxis: evidence from integrating PrEP into routine maternal and child health and family planning clinics in western Kenya.

Author

Roberts, D Allen, Barnabas, Ruanne V, Abuna, Felix, Lagat, Harison, Kinuthia, John, Pintye, Jillian, Bochner, Aaron F, Forsythe, Steven, Gomez, Gabriela B, Baeten, Jared M, John‐Stewart, Grace, and Levin, Carol

Subjects
*PRE-exposure prophylaxis, *FAMILY planning services, *FAMILY health, *HEALTH planning, *CHILDREN'S health, *MATERNAL health
Abstract

Introduction: Understanding the cost of strategies to reach and deliver pre‐exposure prophylaxis (PrEP) to priority populations is essential to assess the cost‐effectiveness and budget impact of HIV prevention programmes. Providing PrEP through maternal and child health and family planning clinics offers a promising strategy to reach women in high HIV burden settings. We estimated incremental costs and explored the cost drivers of integrating PrEP delivery into routine maternal and child health and family planning services in Kenya. Methods: We conducted a costing study from the provider perspective within the PrEP Implementation for Young Women and Adolescents programme in western Kenya. We identified all within‐ and above‐facility activities supporting PrEP delivery and measured clinical service time using time‐and‐motion studies. We obtained input costs from programme budgets, expenditure records and staff interviews. We estimated changes in costs if creatinine testing were postponed from initiation to first follow‐up visit and if PrEP were prioritized to clients at high HIV risk using a behavioural risk assessment tool. We also projected costs under Ministry of Health (MOH) implementation assuming MOH salaries and programme supervision. We estimated annual numbers of PrEP visits from programme data abstracted from 16 facilities between November 2017 and June 2018. We report the cost per client‐month of PrEP dispensed in 2017 USD. Results: For an annual programme output of 24,005 screenings, 4198 PrEP initiations and 4427 follow‐up visits, the average cost per client‐month of PrEP dispensed in the study was $26.52. Personnel, drugs and laboratory tests comprised 43%, 25% and 14% of programme costs respectively. Postponing creatinine testing and prioritizing PrEP delivery to clients at high HIV risk reduced total programme costs by 8% and 14% respectively. In the MOH scenario assuming no changes in outputs, the projected cost per client‐month of PrEP dispensed decreased to $16.54 and total programme costs decreased by 38%. Conclusions: Incremental PrEP costs are sensitive to the service delivery strategy used to engage priority populations. Postponing creatinine testing and prioritizing PrEP delivery to clients at high HIV risk may reduce costs. Context‐specific cost data are crucial to assess the cost‐effectiveness and affordability of PrEP delivery models. [ABSTRACT FROM AUTHOR]

Published
2019
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4. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Author

Soumya Swaminathan, Berrak Bora Basara, Niveen M E Abu-Rmeileh, Shams Eldin Ali Hassan Khalifa, Nadim E. Karam, Jongmin Lee, Roberto Tchio Talongwa, Inga Dora Sigfusdottir, Yang Yang, Stein Emil Vollset, Joseph R. Masci, Daniel Dicker, Maysaa El Sayed Zaki, Shiwei Liu, Valentina Arsić Arsenijević, Ting Wu Chuang, Linhong Wang, Xiao Rong Wang, Bryan K. Phillips, Don C. Des Jarlais, Vasco Manuel Pedro Machado, Vasiliki Stathopoulou, David Phillips, Luke Nyakarahuka, Leslie T. Cooper, Sandra Nolte, Charles R. Newton, Christina Papachristou, Stephen G. Waller, Carlos Magis-Rodriguez, D. Allen Roberts, Elisabete Weiderpass, Aliya Naheed, Andre Keren, Amanda J. Mason-Jones, Karen J. Courville, Ted R. Miller, Kinnari S. Murthy, Bolajoko O. Olusanya, Tommi Vasankari, Kyle J Foreman, Gabriel Alcalá-Cerra, Yousef Khader, Lorenzo Monasta, Austine Olufemi Adeyemo, Rakhi Dandona, Sanjay Basu, Samir Soneji, Rana J. Asghar, Yohannes Adama Melaku, Rafael Alfonso-Cristancho, John Q. Wong, Yoshihiro Kokubo, Young-Ho Khang, Dhruv S. Kazi, Tom Achoki, Homie Razavi, Uche S. Uchendu, Ashish Bhalla, Ferrán Catalá-López, Peggy Pei-Chia Chiang, Kim Moesgaard Iburg, Kaire Innos, Nicholas J K Breitborde, Zacharie Tsala Dimbuene, Elena Alvarez, Vafa Rahimi-Movaghar, Qing Lan, Simon I. Hay, Kaushalendra Kumar, Ubai Alsharif, Scott B. Patten, Gelin Xu, Theo Vos, Kalpana Balakrishnan, Raghib Ali, Marcella Montico, Andrea P. Silva, Robert G. Weintraub, Timothy M. Wolock, Mohammad Ali Sahraian, Heidi J. Larson, Kingsley N. Ukwaja, Saad B. Omer, Scott Weichenthal, D. Alex Quistberg, Justin Beardsley, Chandrashekhar T Sreeramareddy, Jennifer H MacLachlan, Hsien-Ho Lin, H. Dean Hosgood, Karzan Abdulmuhsin Mohammad, Ryan M Barber, Ibrahim Abubakar, Irma Khonelidze, Ileana B. Heredia Pi, Cyrus Cooper, Hilton Lam, Urbano Fra Paleo, Joshua A. Salomon, Ricky Leung, Farshad Pourmalek, Robert G. Nelson, Konstantinos Stroumpoulis, Megan Coggeshall, Mazin J. Al Kahbouri, Richard G. Ellenbogen, Hwashin Hyun Shin, Ida Kankindi, Guohong Jiang, Yanping Wang, Daniel Obadare Fijabi, Carlos A Castañeda-Orjuela, Chakib Nejjari, Diego De Leo, Rashmi Gupta, Gene F. Kwan, Johanna M. Geleijnse, Kenji Shibuya, Hassan Amini, Nsanzimana Sabin, Benjamin C Cowie, Karen M. Tabb, Chanda Kulkarni, Jed D. Blore, Amado D Quezada, Norito Kawakami, Walid Ammar, Van C. Lansingh, François Alla, Seyed-Mohammad Fereshtehnejad, Yichong Li, Vineet K. Chadha, Jasvinder A. Singh, Agnes Binagwaho, Andrew L. Thorne-Lyman, Denis Nash, Palwasha Anwari, Mohammad T Mashal, Kim Yun Jin, Steven E. Lipshultz, Veena S. Kulkarni, Amitava Banerjee, Naohiro Yonemoto, James D. Wilkinson, Aslam Pervaiz, Emilie Agardh, Barthelemy Kuate Defo, Alan D. Lopez, Carl Abelardo T. Antonio, Abraham D. Flaxman, Boris I. Pavlin, Karen Sliwa, Dima M. Qato, G Anil Kumar, Lynne Gaffikin, K.M. Venkat Narayan, Luca Ronfani, Kazem Rahimi, Vivekanand Jha, Gokalp Kadri Yentur, Wagner Marcenes, Giuseppe Remuzzi, Anwar Rafay, Anand Dayama, Robert Quentin Reilly, Alaa Badawi, Selen Begüm Uzun, James Leigh, Vinay Nangia, Ivy Shiue, J Brown, Nobhojit Roy, Genesis May J. Samonte, Edward J Mills, Soewarta Kosen, Atsushi Goto, Sajjad Ur Rahman, Jose C. Adsuar, Semaw Ferede Abera, Jefferson Traebert, Amiran Gamkrelidze, Andrew H. Kemp, Vasiliy Victorovich Vlassov, André Karch, Edgar P. Simard, Aref A. Bin Abdulhak, Samath D Dharmaratne, Ione Jayce Ceola Schneider, Andre Pascal Kengne, Corine Karema, Harish Chander Gugnani, Reza Assadi, Glen Mola, Paulo A. Lotufo, Christopher J L Murray, Rajeev Gupta, Philimon Gona, Mustafa Z. Younis, Herbert C. Duber, Mitchell T. Wallin, Arjun Lakshmana Balaji, Max Petzold, Francesco Saverio Violante, Monika Sawhney, Kovin Naidoo, Mercedes Colomar, Chuanhua Yu, Mitsuru Mukaigawara, Emerito Jose A. Faraon, Jung-Chen Chang, A Artaman, Muhammad Imran Nisar, Dickens Akena, Xiao Nong Zou, Knud Juel, Mohammed I. Albittar, Mohammad Yahya Saeedi, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Graeme J. Hankey, Jerry Puthenpurakal Abraham, Mouhanad Hammami, Zulfiqar A Bhutta, Rintaro Mori, Maia Kereselidze, Josep Maria Haro, Emily Dansereau, Michael Brainin, Elizabeth Glaser, Ziad A. Memish, Anders Larsson, Solomon Meseret Woldeyohannes, Azmeraw T. Amare, Louisa Degenhardt, Yuichiro Yano, Luke D. Knibbs, Sadaf G. Sepanlou, Hilda L Harb, In-Hwan Oh, Katherine B Gibney, Abdullah Sulieman Terkawi, Adansi A. Amankwaa, Nicholas Graetz, Fortuné Gbètoho Gankpé, Vincent Nowaseb, David M. Pereira, Alan J Thomson, Miguel Angel Alegretti, Rupak Shivakoti, Adnan M. Durrani, Dipan Bose, Saleem M Rana, Mohammad Taghi Hedayati, Mohsen Naghavi, Vegard Skirbekk, Walter Mendoza, Ali H. Mokdad, Soraya Seedat, Zewdie Aderaw Alemu, Edson Serván-Mori, Anil Kaul, Foad Abd-Allah, Paul S. F. Yip, Marek Majdan, Peter A. Meaney, Kebede Deribe, Paul N. Jensen, Fabiola Mejía-Rodríguez, Bradford D. Gessner, Ami R. Moore, Marie Ng, Maigeng Zhou, Mohammad H. Forouzanfar, John J Huang, Tim Driscoll, Samia Alhabib, Jun Zhu, Michael H. Criqui, Eduardo Bernabé, Lalit Dandona, Miltiadis K. Tsilimbaris, Borja del Pozo-Cruz, Johan Ärnlöv, Luigi Naldi, Tariku Jibat Beyene, Rasmus Havmoeller, Bongani M. Mayosi, Konrad Pesudovs, Richard A. White, Ejaz Ahmad Khan, Orish Ebere Orisakwe, Graça Maria Ferreira De Lima, Yang Liu, Haidong Wang, Yongmei Li, Bryan L. Sykes, Ronny Westerman, Vinod K. Paul, Angel J Paternina Caicedo, Abigail C. McKay, Eric L. Ding, Narayanaswamy Venketasubramanian, Uur Dilmen, Stephen S Lim, Andrew Vallely, Alireza Esteghamati, Seok Jun Yoon, John Hornberger, Kathryn H. Jacobsen, Yong Zhao, Thomas D. Fleming, Nelson Alvis-Guzman, Damian G Hoy, Hebe N. Gouda, Mall Leinsalu, Elizabeth Johnson, Wilkister N. Moturi, Bach Xuan Tran, Donald H. Silberberg, Yingfeng Zheng, Lydia S. Atkins, Hans W. Hoek, Muluken Dessalegn, David C. Schwebel, Christopher C. Mapoma, Jost B. Jonas, Tolesa Bekele, Ibrahim Abdelmageem Mohamed Ginawi, Bulat Idrisov, Man Mohan Mehndiratta, Thomas N. Williams, Jeffrey A. Towbin, Caterina Guinovart, Jeyaraj D Pandian, Panniyammakal Jeemon, Taavi Lai, Haidong Kan, Tasara T. Mazorodze, Murugesan Raju, Randah R. Hamadeh, Neil Pearce, Melvin Barrientos Marzan, Nima Hafezi-Nejad, John Nelson Opio, Deena Alasfoor, Peter J. Hotez, Jonas Minet Kinge, Peter J. Allen, Eric Y. Tenkorang, Sudan Prasad Neupane, Laith J. Abu-Raddad, Katrina F Ortblad, Arsène Kouablan Adou, Farshad Farzadfar, Sergey Soshnikov, Neeraj Bhala, Sara Sheikhbahaei, Kyle R. Heuton, Michelle L. Bell, Yohannes Kinfu, Takayoshi Ohkubo, Belinda K Lloyd, R. Kumar, Jan Hendrik Richardus, Benjamin O. Anderson, Cell biology, Epidemiology, Public Health, Erasmus MC other, Pathology, Cardiothoracic Surgery, Murray, Christopher J.L, Ortblad, Katrina F., Guinovart, Caterina, Lim, Stephen S., Wolock, Timothy M., Roberts, D. Allen, Dansereau, Emily A., Graetz, Nichola, Barber, Ryan M., Brown, Jonathan C., Wang, Haidong, Duber, Herbert C., Naghavi, Mohsen, Dicker, Daniel, Dandona, Lalit, Salomon, Joshua A., Heuton, Kyle R., Foreman, Kyle, Phillips, David E., Fleming, Thomas D., Flaxman, Abraham D., Phillips, Bryan K., Johnson, Elizabeth K., Coggeshall, Megan S., Abd-Allah, Foad, Abera, Semaw Ferede, Abraham, Jerry P., Abubakar, Ibrahim, Abu-Raddad, Laith J., Abu-Rmeileh, Niveen Me, Achoki, Tom, Adeyemo, Austine Olufemi, Adou, Arsène Kouablan, Adsuar, José C., Agardh, Emilie Elisabet, Akena, Dicken, Al Kahbouri, Mazin J., Alasfoor, Deena, Albittar, Mohammed I., Alcalá-Cerra, Gabriel, Alegretti, Miguel Angel, Alemu, Zewdie Aderaw, Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Alla, Francoi, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Amini, Hassan, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Ärnlöv, Johan, Arsic Arsenijevic, Valentina S., Artaman, Ali, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Badawi, Alaa, Balakrishnan, Kalpana, Banerjee, Amitava, Basu, Sanjay, Beardsley, Justin, Bekele, Tolesa, Bell, Michelle L., Bernabe, Eduardo, Beyene, Tariku Jibat, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bin Abdulhak, Aref, Binagwaho, Agne, Blore, Jed D., Bora Basara, Berrak, Bose, Dipan, Brainin, Michael, Breitborde, Nichola, Castañeda-Orjuela, Carlos A., Catalá-López, Ferrán, Chadha, Vineet K., Chang, Jung-Chen, Chiang, Peggy Pei-Chia, Chuang, Ting-Wu, Colomar, Mercede, Cooper, Leslie Trumbull, Cooper, Cyru, Courville, Karen J., Cowie, Benjamin C., Criqui, Michael H., Dandona, Rakhi, Dayama, Anand, De Leo, Diego, Degenhardt, Louisa, Del Pozo-Cruz, Borja, Deribe, Kebede, Des Jarlais, Don C., Dessalegn, Muluken, Dharmaratne, Samath D., Dilmen, Uur, Ding, Eric L., Driscoll, Tim R., Durrani, Adnan M., Ellenbogen, Richard G., Ermakov, Sergey Petrovich, Esteghamati, Alireza, Faraon, Emerito Jose A., Farzadfar, Farshad, Fereshtehnejad, Seyed-Mohammad, Fijabi, Daniel Obadare, Forouzanfar, Mohammad H., Paleo, Urbano Fra., Gaffikin, Lynne, Gamkrelidze, Amiran, Gankpé, Fortuné Gbètoho, Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Ginawi, Ibrahim Abdelmageem Mohamed, Glaser, Elizabeth L., Gona, Philimon, Goto, Atsushi, Gouda, Hebe N., Gugnani, Harish Chander, Gupta, Rajeev, Gupta, Rahul, Hafezi-Nejad, Nima, Hamadeh, Randah Ribhi, Hammami, Mouhanad, Hankey, Graeme J., Harb, Hilda L., Haro, Josep Maria, Havmoeller, Rasmu, Hay, Simon I., Hedayati, Mohammad T., Heredia Pi, Ileana B., Hoek, Hans W., Hornberger, John C., Hosgood, H. Dean, Hotez, Peter J., Hoy, Damian G., Huang, John J., Iburg, Kim M., Idrisov, Bulat T., Innos, Kaire, Jacobsen, Kathryn H., Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Guohong, Jonas, Jost B., Juel, Knud, Kan, Haidong, Kankindi, Ida, Karam, Nadim E., Karch, André, Karema, Corine Kakizi, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre Pascal, Keren, Andre, Kereselidze, Maia, Khader, Yousef Saleh, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz Ahmed, Khang, Young-Ho, Khonelidze, Irma, Kinfu, Yohanne, Kinge, Jonas M., Knibbs, Luke, Kokubo, Yoshihiro, Kosen, S., Kuate Defo, Barthelemy, Kulkarni, Veena S., Kulkarni, Chanda, Kumar, Kaushalendra, Kumar, Ravi B., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Lakshmana Balaji, Arjun, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Ander, Lee, Jong-Tae, Leigh, Jame, Leinsalu, Mall, Leung, Ricky, Li, Yichong, Li, Yongmei, De Lima, Graça Maria Ferreira, Lin, Hsien-Ho, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Lotufo, Paulo A., Machado, Vasco Manuel Pedro, Maclachlan, Jennifer H., Magis-Rodriguez, Carlo, Majdan, Marek, Mapoma, Christopher Chabila, Marcenes, Wagner, Marzan, Melvin Barriento, Masci, Joseph R., Mashal, Mohammad Taufiq, Mason-Jones, Amanda J., Mayosi, Bongani M., Mazorodze, Tasara T., Mckay, Abigail Cecilia, Meaney, Peter A., Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mills, Edward J., Mohammad, Karzan Abdulmuhsin, Mokdad, Ali H., Mola, Glen Liddell, Monasta, Lorenzo, Montico, Marcella, Moore, Ami R., Mori, Rintaro, Moturi, Wilkister Nyaora, Mukaigawara, Mitsuru, Murthy, Kinnari S., Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nangia, Vinay, Narayan, K.M. Venkat, Nash, Deni, Nejjari, Chakib, Nelson, Robert G., Neupane, Sudan Prasad, Newton, Charles R., Ng, Marie, Nisar, Muhammad Imran, Nolte, Sandra, Norheim, Ole F., Nowaseb, Vincent, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orisakwe, Orish Ebere, Pandian, Jeyaraj D., Papachristou, Christina, Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris Igor, Pearce, Neil, Pereira, David M., Pervaiz, Aslam, Pesudovs, Konrad, Petzold, Max, Pourmalek, Farshad, Qato, Dima, Quezada, Amado D., Quistberg, D. Alex, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rana, Saleem M., Razavi, Homie, Reilly, Robert Quentin, Remuzzi, Giuseppe, Richardus, Jan Hendrik, Ronfani, Luca, Roy, Nobhojit, Sabin, Nsanzimana, Saeedi, Mohammad Yahya, Sahraian, Mohammad Ali, Samonte, Genesis May J., Sawhney, Monika, Schneider, Ione J.C., Schwebel, David C., Seedat, Soraya, Sepanlou, Sadaf G., Servan-Mori, Edson E., Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin Hyun, Shiue, Ivy, Shivakoti, Rupak, Sigfusdottir, Inga Dora, Silberberg, Donald H., Silva, Andrea P., Simard, Edgar P., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soneji, Samir, Soshnikov, Sergey S., Sreeramareddy, Chandrashekhar T., Stathopoulou, Vasiliki Kalliopi, Stroumpoulis, Konstantino, Swaminathan, Soumya, Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto Tchio, Tenkorang, Eric Yeboah, Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Towbin, Jeffrey A., Traebert, Jefferson, Tran, Bach X., Tsala Dimbuene, Zacharie, Tsilimbaris, Miltiadi, Uchendu, Uche S., Ukwaja, Kingsley N., Uzun, Selen Begüm, Vallely, Andrew J., Vasankari, Tommi J., Venketasubramanian, N., Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Waller, Stephen, Wallin, Mitchell T., Wang, Linhong, Wang, Xiao Rong, Wang, Yanping, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Westerman, Ronny, White, Richard A., Wilkinson, James D., Williams, Thomas Neil, Woldeyohannes, Solomon Meseret, Wong, John Q., Xu, Gelin, Yang, Yang C., Yano, Yuichiro, Yentur, Gokalp Kadri, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa, Yu, Chuanhua, Jin, Kim Yun, El Sayed Zaki, Maysaa, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zou, Xiao Nong, Lopez, Alan D., and Vos, Theo

Subjects
Gerontology, SEVERE FEBRILE ILLNESS, Male, verbal autopsy, Nutrition and Disease, Cost effectiveness, MILLENNIUM DEVELOPMENT GOALS, HIV Infections, active antiretroviral therapy, Global Health, COST-EFFECTIVENESS, 0302 clinical medicine, Voeding en Ziekte, Global health, HIV Infection, 030212 general & internal medicine, 0303 health sciences, ACTIVE ANTIRETROVIRAL THERAPY, Incidence (epidemiology), Medicine (all), Incidence, General Medicine, Millennium Development Goals, 3. Good health, middle-income countries, projection package, World Health, VERBAL AUTOPSY, Female, Human, Tuberculosis, Tuberculosi, PROJECTION PACKAGE, prospective cohort, Epidemic, millennium development goals, 03 medical and health sciences, Age Distribution, Acquired immunodeficiency syndrome (AIDS), SDG 3 - Good Health and Well-being, MIDDLE-INCOME COUNTRIES, medicine, Organizational Objective, Humans, Organizational Objectives, FEMALE SEX WORKERS, Mortality, Sex Distribution, Epidemics, cost-effectiveness, female sex workers, 030304 developmental biology, VLAG, business.industry, plasmodium-falciparum malaria, PLASMODIUM-FALCIPARUM MALARIA, medicine.disease, Verbal autopsy, Malaria, PROSPECTIVE COHORT, severe febrile illness, business, Demography
Abstract

BACKGROUND: The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration.METHODS: To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010-13) of incidence, drug resistance, and coverage of insecticide-treated bednets.FINDINGS: Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990.INTERPRETATION: Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. The number of people living with HIV, tuberculosis, or malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action.FUNDING: Bill & Melinda Gates Foundation.

Published
2014

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