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Table 1 Description of scenarios

From: Modelling the effect of short-course multidrug-resistant tuberculosis treatment in Karakalpakstan, Uzbekistan

Scenario Programmatic implementation and evidence Model implementation
1. Baseline programmatic conditions continued   All 2014 programmatic parameters remain unchanged (including 24 month duration of MDR-TB regimen and 400 treatment places available at any one time being the limiting factor for treatment commencement in 2014)
2A. Short-course MDR-TB regimen Change from standard WHO regimen to short-course regimen [69] Total period of time on treatment for MDR-TB regimens decreases from a mean of 24 months to 10 months (with treatment places remaining capped at 400)
2B. Short-course MDR-TB regimen with improved outcomes As for short-course regimen, with improvement in treatment outcomes [6] Treatment outcomes improve to a treatment success rate of 87.9% (with ratio of deaths to defaults under treatment unchanged), in addition to changes modelled under short-course regimen scenario above
3. Decreased delays to detection for all forms of TB (first comparator) Active or intensified case finding halves the period of time to first presentation from baseline value [28, 29] Time from disease onset to correct identification of patients as having active TB halves (with no change to the proportion correctly identified as to their infecting strain)
4. Improved MDR-TB treatment outcomes (second comparator) Social support for all patients on treatment halves the proportion of outcomes resulting in interruption/failure or death [30] Proportion of patients interrupting/failing or dying on treatment halves (with treatment success proportion increasing to 1 – [1 – previous treatment success proportion] ÷ 2)
5. Improved MDR-TB identification (third comparator) Halve the number of health facilities without access to drug-susceptibility testing (e.g. Xpert MTB/RIF), thereby halving the proportion of patients not recognised as MDR-TB at presentation [31, 32] Proportion of patients with MDR-TB who are incorrectly diagnosed as having DS-TB halves (with correct diagnosis proportion increasing to 1 – [1 – previous correct identification proportion] ÷ 2)
6. Increased MDR-TB treatment availability (fourth comparator) Increased resources doubles the number of patients that can be simultaneously treated Increase number of MDR-TB treatment places available to 800 (with DS-TB and XDR-TB treatment capacity unchanged)
  1. DS-TB Drug-susceptible tuberculosis, MDR-TB Multidrug-resistant tuberculosis, TB Tuberculosis, WHO World Health Organization, XDR-TB Extensively drug-resistant tuberculosis