Epidemiological Modeling of TB Elimination. David Dowdy, MD PhD Union-NAR Meeting Feb. 25, 2016
|
|
- Veronica Bishop
- 5 years ago
- Views:
Transcription
1 Epidemiological Modeling of TB Elimination David Dowdy, MD PhD Union-NAR Meeting Feb. 25, 2016
2 Objectives Describe the role of modeling in exploring strategies for TB elimination, in both high- and low-burden contexts Describe challenges in modeling TB transmission in the elimination phase Reactivation > transmission Migration and mixing Increasing importance of outbreaks Describe the results of modelling studies that focus on the elimination of TB
3 Background: TB Elimination Definition: <1 case per million per year Action Framework: 8 Priority Actions How close are we?
4 Background: TB Elimination Definition: <1 case per million per year Action Framework: 8 Priority Actions How close are we? 2014: 9,421 cases Elimination: 319 cases/year U.S. Centers for Disease Control and Prevention
5 Background: TB Elimination Definition: <1 case per million per year Action Framework: 8 Priority Actions How close are we? To achieve elimination, we must prevent 29 out of 30 TB cases that currently occur in the United States. 2014: 9,421 cases Elimination: 319 cases/year U.S. Centers for Disease Control and Prevention
6 29 Out of 30: Consider TB incidence in the USA in 2014 fell by 2.2%. About the same rate of decline as seen globally At a 2.2%/year decline, we will achieve elimination in the year Two-thirds of all cases occur in the foreign-born. Zero decline in foreign-born cases since 2012 Preventing all cases except those among people arriving in the past year would still leave us at twice the elimination threshold. Best estimates of the percent of TB cases reflecting recent transmission within U.S. borders: 5-15% Interrupting all TB transmission within the USA would prevent 2-4 out of 30 cases.
7 Transmission Models of TB Dowdy, Dye, Cohen; IJTLD 2013 Commonly used to evaluate impact of TB interventions on future transmission. As the prevalence of TB declines, the rate of infection (1) falls. Capture dynamics that may not be seen in statistical analyses alone.
8 TB Transmission Modeling Example Choose a population you wish to model. Southeast Asia: high TB incidence, low HIV Describe the likely effects of new interventions. Example: new diagnostics shorten time to treatment by 3-4 months Project TB incidence and mortality over time. Including the impact of each intervention
9 Challenges in Modeling TB Elimination Transmission is not the key to elimination. Migration can drive dynamics. Outbreaks and local effects become more important.
10 Interrupting Transmission Elimination At least three existing models of TB elimination exist: Hill A et al (Epidemiol Infect 2012): Modeling TB trends in the USA Dye et al (Annu Rev Public Health 2013): Prospects for global TB elimination Hill P et al (IJTLD 2014): Mass TB treatment to eliminate TB in Kiribati All agree on one thing: Elimination in any reasonable time frame will require preventive therapy on a massive scale. Do we need transmission models? Arguably, can just calculate the number of people infected (by risk group) and estimate the coverage required. Bad news: Likely have to treat people (e.g., elderly foreign-born) for whom the risks of treatment outweigh the benefits.
11 Interrupt transmission Treat 17% of LTBI every year Model of eliminating TB in the USA Interrupting transmission has relatively small impact on the epidemic Can eliminate TB in the US-born (continuing current trends) by 2056 Cannot eliminate TB in the USA by 2060, even with massive treatment of LTBI and 75% reduction of LTBI among FB arrivals
12 Model of eliminating TB globally Interrupting transmission leaves us 100x above elimination threshold To achieve elimination, would need to: Treat 14% of the world s population with LTBI per year (equivalent to treating the entire US population, every year) And interrupt transmission of active disease
13 Model of mass treatment of active TB in Kiribati Detecting 96% of all cases and treating them effectively gets us to 1000x the elimination threshold. Can achieve elimination in 2035 by treating everyone in the population for active TB, every 5 years, with 95% efficacy.
14 Bottom Line If we are seeking to eliminate TB, we must focus on prevention in addition to transmission. And be prepared to do so on a massive scale Do we need transmission models? Arguably, can calculate the number of people infected (by risk group) and estimate the coverage required. Bad news: Likely have to treat people (e.g., elderly foreign-born) for whom the risks of treatment outweigh the benefits. Is this vaccine case an argument we can make for TB elimination?
15 Role of Migration Elimination in low-incidence settings depends on progress globally. Two-thirds of the TB incidence in the USA reflects infection acquired abroad. Migration and mixing are key drivers of TB transmission. Difficult to model: do individuals who are foreign-born/homeless/etc mix exclusively with other people of the same group? Immigrants to the USA are not representative of the home country population. TB incidence in the first year after arrival is already half the expected reactivation rate in home countries. Reflects pre-immigration screening, higher SES, etc. How much with imported TB fall if global TB declines by 50%?
16 Migration and Mixing Shrestha et al; in revision Mixing between hotspots and general population may be a critical driver of TB incidence. The hotspots in low-incidence settings are Latin America, Asia, & Africa. Better understanding of these dynamics is critical if we are to model TB elimination. Though arguably even more important in high-burden settings, where most active TB still represents recent transmission.
17 Outbreaks As TB epidemics approach elimination, they become less predictable. Two outbreaks of 3 cases each would be sufficient to take the entire state of Colorado above the elimination threshold for a year. Traditional models become more difficult to fit and less useful in making projections. Relevant question becomes how do we prevent outbreaks rather than what is the expected number of cases. Resource use also becomes more difficult to justify. Fojo et al, SGIM abstract under review
18 Models: Helpful or Not? Models: Helpful How is TB likely to be different in the elimination phase? What are likely to be the key drivers of future TB epidemics? What is the comparative impact of different interventions? How important are factors like immigration and outbreaks? Can we better understand the role of transmission vs. reactivation? If current trends continue, will TB incidence plateau? Models: Less Helpful When will we reach TB elimination in the USA? If TB funding is cut by $XX million, what will the impact on incidence be? If we implement intervention X, exactly how many cases will we avert? Where is the next outbreak going to occur? How many cases of TB have we averted through TLBTI to date? What is our TB incidence going to be in 2030?
19 TB Modeling as an Iterative Process Knight et al, IJID 2016
20 Summary Elimination of TB is a very ambitious goal. Must avert 29 of every 30 current cases in the USA Modeling of TB elimination involves specific challenges. Smaller contribution of transmission Migration and mixing of populations Larger role of unpredictable outbreaks TB elimination models should be developed collaboratively with public health practitioners. Models are more useful for understanding than for prediction. When put to good use, important insight can be gained.
21 Acknowledgments JHSPH TB Modeling and Translational Epi Group Sourya Shrestha, Todd Fojo, Alice Zwerling, Andrew Azman NYC DOHMH Natalie Stennis, Shama Ahuja CDC TB NEEMA Team Suzanne Marks, Andrew Hill, Nick Menzies, Josh Salomon, Travis Porco, Alex Goodall Other Collaborators Gwen Knight, Nila Dharan, Ted Cohen, Susmita Chatterjee
Drivers of TB Transmission
Drivers of TB Transmission David Dowdy, MD PhD National TB Conference Atlanta, GA April 20, 2017 Motivation Ending TB transmission in the US is necessary (but not sufficient) for TB elimination. We will
More informationCurrent and future trends in tuberculosis incidence in New York City: a dynamic modelling analysis
Current and future trends in tuberculosis incidence in New York City: a dynamic modelling analysis Anthony T Fojo, Natalie L Stennis, Andrew S Azman, Emily A Kendall, Sourya Shrestha, Shama D Ahuja, David
More informationProgrammatic management of LTBI : a two pronged approach for ending the TB epidemic. Haileyesus Getahun Global TB Programme WHO/HQ
Programmatic management of LTBI : a two pronged approach for ending the TB epidemic Haileyesus Getahun Global TB Programme WHO/HQ What is latent TB infection? A state of persistent immune response to stimulation
More informationContact Investigation and Prevention in the USA
Contact Investigation and Prevention in the USA George D. McSherry, MD Division of Infectious Disease Penn State Children s Hospital Pediatric Section TB Center of Excellence Rutgers Global Tuberculosis
More informationIntroduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa
Introduction to Measles a Priority Vaccine Preventable Disease (VPD) in Africa Nigeria Center for Disease Control Federal Ministry of Health Abuja July 2015 Outline 1. Measles disease 2. Progress towards
More informationGLOBAL HIV STATISTICS
F A C T S H E E T W O R L D A I D S D A Y 2017 GLOBAL HIV STATISTICS 20.9 million people were accessing antiretroviral therapy in June 2017. 36.7 million [30.8 million 42.9 million] people globally were
More informationPediatric Tuberculosis in Los Angeles County: An Update
Pediatric Tuberculosis in Los Angeles County: An Update Julie Higashi, MD PhD Director, Tuberculosis Control Program March 2, 2019 0 Pediatricians will be the driving force of TB elimination in California
More informationExpanding Latent Tuberculosis Infection Testing and Treatment to Accelerate Tuberculosis Elimination
IUATLD North American Region Conference February 24, 2017 Vancouver, BC Expanding Latent Tuberculosis Infection Testing and Treatment to Accelerate Tuberculosis Elimination Philip LoBue, MD National Center
More informationThe WHO END-TB Strategy
ENDING TB and MDR-TB The WHO END-TB Strategy Dr Mario RAVIGLIONE Director Joint GDI/GLI Partners Forum WHO Geneva, 27 April 2015 This talk will deal with TB Burden Progress, Challenges Way Forward Who
More informationIn 2013, around 12.9 million people living with HIV had access to antiretroviral therapy.
F A C T S H E E T 2014 GLOBAL STATISTICS People living with HIV In 2013, there were 35 [33.2 37.2 ] people living with HIV. - Since the start of the epidemic, around 78 [71 87 ] people have become infected
More informationTuberculosis Elimination Jennifer Flood, MD, MPH Pennan Barry, MD, MPH NAR-NTCA February 25, 2016
Tuberculosis Elimination Jennifer Flood, MD, MPH Pennan Barry, MD, MPH NAR-NTCA February 25, 2016 Picture source: http://www.lovethispic.com/uploaded_images/12860-california-dreamin.jpg Questions What
More informationCalifornia s Experiences Using Tuberculosis Whole Genome Sequencing
California s Experiences Using Tuberculosis Whole Genome Sequencing Martin Cilnis MS, MPH Epidemiologist California Department of Public Health, TB Control Branch, Outbreak Prevention and Control Section
More informationEpidemiology of Tuberculosis Denver TB Course
Epidemiology of Tuberculosis Denver TB Course Randall Reves, MD, MSc Volunteer Clinician Denver Metro TB Program and Division of Infectious Diseases, Department of Medicine University of Colorado Denver
More informationEstimating TB burden. Philippe Glaziou World Health Organization Accra, Ghana
Estimating TB burden Philippe Glaziou World Health Organization Accra, Ghana Outline Basic facts about TB epidemiology What should we expect with regards TB burden over time? Main indicators of TB disease
More informationTuberculosis-related deaths in people living with HIV have fallen by 36% since 2004.
F A C T S H E E T 2014 GLOBAL STATISTICS People living with HIV In 2013, there were 35 [33.2 37.2 ] people living with HIV. - Since the start of the epidemic, around 78 [71 87 ] people have become infected
More informationResponding to a TB Event Bismarck, North Dakota June 24-25, 2008
Responding to a TB Event Bismarck, North Dakota June 24-25, 2008 TB Epidemiology: Global and State Lynelle Phillips, RN, MPH June 24, 2008 TB Epidemiology Global and State Lynelle Phillips RN MPH Nurse
More informationTuberculosis Screening and Targeted Testing of College and University Students: Developing a Best Practice Approach:
Tuberculosis Screening and Targeted Testing of College and University Students: Developing a Best Practice Approach: Lori A. Soos MA, BSN, RN, Niagara University Deborah Penoyer, MS, RN, SUNY Geneseo Learning
More informationWASHINGTON STATE COMMUNICABLE DISEASES OF PUBLIC HEALTH SIGNIFICANCE FOR THE CIVIL SURGEON
WASHINGTON STATE COMMUNICABLE DISEASES OF PUBLIC HEALTH SIGNIFICANCE FOR THE CIVIL SURGEON SCOTT LINDQUIST MD MPH WASHINGTON STATE DEPARTMENT OF HEALTH STATE EPIDEMIOLOGIST FOR COMMUNICABLE DISEASES FOREIGN-BORN
More informationGlobal, National, Regional
Epidemiology of TB: Global, National, Regional September 13, 211 Edward Zuroweste, MD Chief Medical Officer Migrant Clinicians Network Assistant Professor of Medicine Johns Hopkins School of Medicine Epidemiology
More informationHow can TB elimination models inform program strategies today?
How can TB elimination models inform program strategies today? Modeling by the CDC and the NCHHSTP Epidemiologic and Economic Modeling Agreement (NEEMA) Grantees Suzanne Marks, MPH, MA CDC/Division of
More informationSubstance Abuse and Tuberculosis Springfield, IL April 27, 2011
5/6/2011 Substance Abuse and Tuberculosis Springfield, IL April 27, 2011 Epidemiology of Substance Abuse and Tuberculosis: Where is the Problem? Debra Stephens, RN, BSN, MPH April 27, 2011 Debra Stephens,
More informationHow has the Polio Eradication Initiative influenced the global AIDS response? Bradley S. Hersh, MD, MPH
How has the Polio Eradication Initiative influenced the global AIDS response? Bradley S. Hersh, MD, MPH Presentation Outline Big history of global HIV epidemic Current status of HIV and the global AIDS
More informationCalifornia s Experiences Using Tuberculosis Whole Genome Sequencing
California s Experiences Using Tuberculosis Whole Genome Sequencing Martin Cilnis MS, MPH Epidemiologist California Department of Public Health, TB Control Branch, Outbreak Prevention and Control Section
More informationHIV/AIDS in East Asia
HIV/AIDS in East Asia Yonsei University Graduate School of Global Health Sohn, Myong Sei Epidemiology Global summary of the AIDS epidemic, 2008 Number of people living with HIV in 2008 Total Adults Women
More informationCost-Effectiveness Analysis of TB Diagnostics David Dowdy Challenges and Future Directions
Cost-Effectiveness Analysis of TB Diagnostics David Dowdy ddowdy@jhsph.edu Challenges and Future Directions Objectives Provide an overview of cost-effectiveness analysis (CEA) as applied to TB diagnostics
More informationDENGUE AND BLOOD SAFETY. Ester C Sabino, MD, PhD Dep. of Infectious Disease/Institute of Tropical Medicine University of São Paulo
DENGUE AND BLOOD SAFETY Ester C Sabino, MD, PhD Dep. of Infectious Disease/Institute of Tropical Medicine University of São Paulo Dengue virus Arbovirus (arthropod-borne virus) virus transmitted by mosquitoes:
More informationState Of Tuberculosis Elimination in the United States, 2017
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention State Of Tuberculosis Elimination in the United States, 2017 Philip LoBue, MD Director, Division of Tuberculosis Elimination Congressional
More informationCopyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN
UNAIDS DATA TABLES 2011 Copyright 2011 Joint United Nations Programme on HIV/AIDS (UNAIDS) All rights reserved ISBN 978-92-9173-945-5 UNAIDS / JC2225E The designations employed and the presentation of
More informationTB Outbreak Investigation in Fishery Workers, Maryland. Cassandra Althauser PHASE Internship Maryland Department of Health and Human Hygiene
TB Outbreak Investigation in Fishery Workers, Maryland Cassandra Althauser PHASE Internship Maryland Department of Health and Human Hygiene Airborne Transmission Tuberculosis Small droplet nuclei (
More informationChapter 1 Overview of Tuberculosis Epidemiology in the United States
Chapter 1 Overview of Tuberculosis Epidemiology in the United States Table of Contents Chapter Objectives.... 1 Progress Toward TB Elimination in the United States... 3 TB Disease Trends in the United
More informationTuberculosis and Diabetes
Tuberculosis and Diabetes National Web-based Seminar Francis J. Curry National TB Center San Francisco, California December 1, 29 Jane Kelly, M.D. Centers for Disease Control and Prevention jkelly@cdc.gov
More informationDiagnosis Latent Tuberculosis. Disclosures. Case
Diagnosis Latent Tuberculosis Neha Shah MD MPH Field Medical Officer Tuberculosis Control Branch California Department of Public Health Centers for Disease Control and Prevention September 2016 1 Disclosures
More informationGLOBAL STATISTICS FACT SHEET 2015
FACT SHEET 2015 GLOBAL STATISTICS 15.8 people accessing antiretroviral therapy (June 2015) 36.9 [34.3 41.4 ] people globally were living with HIV (end 2014) 2 [1.9 2.2 ] people became newly infected with
More informationINSTRUCTOR S NOTE. Copyright 2018, The Johns Hopkins University and Teaching Vaccine Economics Everywhere.
INSTRUCTOR S NOTE This case study can be used to motivate several learning objectives and can be tied to specific course objectives in the modules. In case studies the students are not spoon-fed. Instead,
More informationInfectious DISEASE Report
Infectious DISEASE 2014 Report Introduction For an electronic copy of the 2014 Disease Report ramseycounty.us The 2014 Disease Report provides final numbers, rates and trends for selected reportable diseases
More informationDetection and Treatment of Tuberculosis in Correctional Facilities: Opportunities and Challenges
Detection and Treatment of Tuberculosis in Correctional Facilities: Opportunities and Challenges David Karol, MD, MA Bureau of Prisons, FMC Butner Duke University Medical Center June 26, 2013 No Disclosures
More informationTuberculosis Epidemiology
Tuberculosis Epidemiology TB CLINICAL INTENSIVE COURSE Curry International Tuberculosis Center October 18, 2017 Varsha Hampole, MPH Tuberculosis Control Branch California Department Of Public Health Outline
More informationCHILDHOOD TUBERCULOSIS: NEW WRINKLES IN AN OLD DISEASE [FOR THE NON-TB EXPERT]
CHILDHOOD TUBERCULOSIS: NEW WRINKLES IN AN OLD DISEASE [FOR THE NON-TB EXPERT] QUESTION: : Which children in the United States should get a tuberculin skin test? Do questionnaires really work? Jeffrey
More informationTB-Free California: How close are we? How can we get closer?
TB-Free California: How close are we? How can we get closer? California TB Controllers Association April 21, 2015 Pennan Barry, MD, MPH Chief, Surveillance and Epidemiology Section Acknowledgments Local
More informationElimination of mother to child transmission of HIV: is the end really in sight? Lisa L. Abuogi, MD University of Colorado, Denver Dec 3, 2014
Elimination of mother to child transmission of HIV: is the end really in sight? Lisa L. Abuogi, MD University of Colorado, Denver Dec 3, 2014 Outline Background History of prevention of mother to child
More informationOkinawa, Toyako, and Beyond: Progress on Health and Development
Okinawa, Toyako, and Beyond: Progress on Health and Development Prof. Michel D. Kazatchkine Executive Director The Global Fund to Fight AIDS, Tuberculosis and Malaria United Nations University, Tokyo,
More informationProgram to control HIV/AIDS
90-90-90 Program to control HIV/AIDS Hamid Sharifi Associate Professor in Epidemiology [sharifihami@gmail.com] 1 Targets for ending the AIDS epidemic 2 New HIV infections in low- and middle-income countries,
More informationThe Tip of the Iceberg: Addressing Latent Tuberculosis Infection to Accelerate Tuberculosis Elimination
Four Corners TB and HIV Conference November 3, 2015 Durango, CO The Tip of the Iceberg: Addressing Latent Tuberculosis Infection to Accelerate Tuberculosis Elimination Philip LoBue, MD National Center
More informationCDC s Response to the Viral Hepatitis/Opioid Syndemic
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division of Viral Hepatitis CDC s Response to the Viral Hepatitis/Opioid Syndemic A Blythe Ryerson, PhD, MPH Associate Director for
More informationLTBI monitoring and evaluation in the Netherlands
LTBI monitoring and evaluation in the Netherlands 17 th Wolfheze Workshops 2015, Den Haag Connie Erkens MD MPH Senior TB consultant Content presentation Epidemiology Target groups for programmatic LTBI
More informationEpidemiology of measles in infants younger than 6 months: analysis of surveillance data
Epidemiology of measles in infants younger than 6 months: analysis of surveillance data 2011-2016 An analysis of the epidemiology of measles in infants younger than 6 months was conducted by the U.S. CDC
More informationTuberculosis & Refugees in Philadelphia
Tuberculosis & Refugees in Philadelphia Philadelphia TB Control Program Daniel P. Dohony, MPH Philadelphia TB Control Program Health Information Portal Website: hip.phila.gov Contains Information On» Disease
More informationYellow Fever Vaccine
The Market Shaping Goal Shape vaccine markets to ensure adequate supply of appropriate, quality vaccines at low and sustainable prices for developing countries. Supply and Procurement Roadmap Yellow Fever
More informationPress Release. Date: 24 March Re: Launch of the Online TB Surveillance Dashboard
Centre for Tuberculosis 1 Modderfontein Road, Sandringham, 2031 Tel: +27 (0)11 386 6400 Fax: +27 (0)11 882 0596 Reference: WTD-TB Dashboard Press Release Date: 24 March 2017 Re: Launch of the Online TB
More informationEliminating the Public Health Problem of Hepatitis B and C in the United States BOARD ON POPULATION HEALTH AND PUBLIC HEALTH PRACTICE
Eliminating the Public Health Problem of Hepatitis B and C in the United States The Burden of Hepatitis B and C Every year, viral hepatitis kills more people worldwide than road traffic injuries, diabetes,
More informationModelling The Impact of BCG Vaccines on Tuberculosis Epidemics
Journal of Mathematical Modelling and Application 2014, Vol. 1, No. 9, 49-55 ISSN: 2178-2423 Modelling The Impact of BCG Vaccines on Tuberculosis Epidemics S.A. Egbetade Department of Mathematics and Statistics,
More informationScaling up priority HIV/AIDS interventions in the health sector
TOWARDS UNIVERSAL ACCESS? Scaling up priority HIV/AIDS interventions in the health sector Yves Souteyrand, WHO October 2011 Towards universal access targets UN General Assembly High level Meeting June
More informationThe Global Cancer Epidemic. Tim Byers MD MPH Colorado School of Public Health
The Global Cancer Epidemic Tim Byers MD MPH Colorado School of Public Health This year there will be more deaths in the World from cancer than from: Combined This year there will be more deaths in the
More informationA Mathematical Model for the Epidemiology of Tuberculosis with Estimate of the Basic Reproduction Number
IOSR Journal of Mathematics (IOSR-JM) e-issn: 2278-5728. Volume 5, Issue 5 (Mar. - Apr. 2013), PP 46-52 A Mathematical Model for the Epidemiology of Tuberculosis with Estimate of the Basic Reproduction
More informationTuberculosis Elimination
Tuberculosis Elimination Where We ve Been, Where We re Going Mark Lobato, MD New England TB Consultant Division of Tuberculosis Elimination Centers for Disease Control and Prevention Disclosures / Disclaimer
More information4/25/2012. The information on patterns of infection and disease can assist in: Assessing current and evolving trends in TB
Sindy M. Paul, MD, MPH, FACPM May 1, 2012 The information on patterns of infection and disease can assist in: Assessing current and evolving trends in TB morbidity, including resistance Identifying people
More informationGlobal, National, Regional
Epidemiology of TB: Global, National, Regional September 13, 211 Edward Zuroweste, MD Chief Medical Officer Migrant Clinicians Network Assistant Professor of Medicine Johns Hopkins School of Medicine Epidemiology
More informationMalaria DR. AFNAN YOUNIS
Malaria DR. AFNAN YOUNIS Objectives: Epidemiology of malaria Clinical picture Mode of transmission Risk factors Prevention and control Malaria is a life-threatening disease caused by Plasmodium parasites
More informationEliminating Chronic Hepatitis B Disparities among Asian Pacific Islanders: A Model for Transforming Public Health in the Pacific
Eliminating Chronic Hepatitis B Disparities among Asian Pacific Islanders: A Model for Transforming Public Health in the Pacific Augustina Manuzak, MD, MPH, PhD Augustina.manuzak@doh.hawaii.gov 10/10/2012
More informationUpdate on TB Vaccines
Update on TB Vaccines Hennie Geldenhuys 11 May 2012 A safe and effective TB Vaccine within a decade A Strategic Blueprint for the Next Decade Tuberculosis, Vol 92, March 2012, Suppl. 1, pgs S1-S35 On
More informationTB surveillance. Philippe Glaziou Dubrovnik, May 2009
TB surveillance Philippe Glaziou Dubrovnik, May 2009 What are the global TB targets? Outcome targets (World Health Assembly, STB Partnership) Case detection ratio > 70% Treatment success > 85% 2015 Impact
More informationThe Syndemics of HIV, Hepatitis, and Overdose
The Syndemics of HIV, Hepatitis, and Overdose Sara Zeigler Associate Director for Policy Office of Policy, Planning and Partnerships (proposed) Centers for Disease Control and Prevention National Center
More informationInvesting for Impact
Global Fund Strategic Framework: Investing for Impact M&E: Capturing data to improve services Workshop to Scale Up the Implementation of Collaborative TB/HIV Activities in Africa 10-11 April, 2013; Maputo,
More informationLTBI: Who to Test & When to Treat
LTBI: Who to Test & When to Treat TB Intensive May 10 th, 2016 David Horne, MD, MPH Harborview Medical Center University of Washington DISCLOSURES I have no disclosures or conflicts of interest to report
More informationREPORT FROM THE COMMISSION. Annual Report ( )
EUROPEAN COMMISSION Brussels, 18.12.2012 COM(2012) 775 final REPORT FROM THE COMMISSION Annual Report (-) on the application of Council Regulation (EC) No 953/2003 of 26 May 2003 to avoid trade diversion
More informationHigh Impact Prevention: Science, Practice, and the Future of HIV
High Impact Prevention: Science, Practice, and the Future of HIV Jonathan Mermin, MD, MPH National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention
More informationTB EPIDEMIOLOGY. Outline. Estimated Global TB Burden, TB epidemiology
TB EPIDEMIOLOGY TB Clinical Intensive Course Curry International Tuberculosis Center September 30, 2015 Varsha Nimbal, MPH Tuberculosis Control Branch California Department of Public Health 1 Outline TB
More informationART for prevention the task ahead
ART for prevention the task ahead Dr Teguest Guerma WHO/HQS WHO's role and vision Status of the epidemic Overview Progress and challenges in treatment and prevention scale up ART for prevention Questions
More informationHIV/AIDS IN FOREIGN-BORN NEW YORKERS
HIV/AIDS IN FOREIGN-BORN NEW YORKERS Ellen Weiss Wiewel, MHS HIV Epidemiology and Field Services Program New York City Department of Health and Mental Hygiene http://www.nyc.gov/html/doh/html/dires/hivepi.shtml
More informationProgram Collaboration and Service Integration
Program Collaboration and Service Integration One Size Does Not Fit All Amanuel Rosario, MD Medical Director, TB Control District of Columbia Department of Health Marcelo Fernandez-Viña, MPH Adult Viral
More informationProjected Demand for HIV Diagnostic Tests
Projected Demand for HIV Diagnostic Tests John Stover, Yu Teng, Adebiyi Adesina, Eline Korenromp On behalf of the Diagnostics Forecasting Technical Working Group (CDC, CHAI, GFATM, PfSCM, UNAIDS, UNICEF,
More informationCost-Effectiveness of Preventing Tuberculosis in Prison Populations Zachary Taylor, M.D., M.S., and Cristy Nguyen, M.P.H.
109 Cost-Effectiveness of Preventing Tuberculosis in Prison Populations Zachary Taylor, M.D., M.S., and Cristy Nguyen, M.P.H. Reported TB Cases, United States, 1953 97 110 Reported TB Cases, United States,
More informationChallenges of use of cholera vaccines in Haiti and the Americas
http://www.paho.org Challenges of use of cholera vaccines in Haiti and the Americas Dr. Cuauhtémoc Ruiz Matus Comprehensive Family Immunization Program Background Topics Consultations at PAHO Challenges
More information7.5 South-East Asian Region: summary of planned activities, impact and costs
PART II: GLOBAL AND REGIONAL SCENARIOS FOR TB CONTROL 26 215 7.5 South-East Asian Region: summary of planned activities, impact and costs Achievements DOTS expanded rapidly in the South-East Asian Region
More informationProgrammatic management of latent TB infection: Global perspective and updates. Haileyesus Getahun, MD, MPH, PhD.
Programmatic management of latent TB infection: Global perspective and updates Haileyesus Getahun, MD, MPH, PhD. What is latent TB infection? A state of persistent immune response to stimulation by Mycobacterium
More informationTB is Global. Latent TB Infection (LTBI) Sharing the Care: Working Together. September 24, 2014
Sharing the Care: Working Together to Meet the Challenge of TB Presented by: Barbara Cole, RN, PHN, MSN Director, Disease Control County of Riverside Department of Public Health Curry International TB
More information2010 global TB trends, goals How DOTS happens at country level - an exercise New strategies to address impediments Local challenges
Outline of what it will take Tuberculosis Elimination 25: Global and Local Challenges Anne Fanning, MD November 9, 211 21 global TB trends, goals How DOTS happens at country level - an exercise New strategies
More informationColloque scientifique : L économie de la prévention Analysis of Cost-Effectiveness of HIV Prevention
Colloque scientifique : L économie de la prévention Analysis of Cost-Effectiveness of HIV Prevention Julia Walsh MD, MSc Professor School of Public Health University of California Berkeley Objectives Cost-effectiveness
More informationThresia Sebastian MD, MPH University of Colorado, Denver Global Health Disasters Course October 2016
Thresia Sebastian MD, MPH University of Colorado, Denver Global Health Disasters Course October 2016 1 Objectives of today s lecture Describe global goals in the fight against HIV Review the epidemiology
More informationThe American Experience with TB Elimination
Reaching the Goal of TB Elimination by 2035 March 3, 2015 The American Experience with TB Elimination John Jereb, M.D. Medical officer Division of Tuberculosis Elimination National Center for HIV/AIDS,
More informationJessica Quintero, BAAS has the following disclosures to make:
Special Considerations and Frequently Asked Questions in a Contact Investigation Jessica Quintero, BAAS September 24, 2015 TB Nurse Case Management September 22 24, 2015 San Antonio, Texas EXCELLENCE EXPERTISE
More informationTowards universal access
Key messages Towards universal access Scaling up priority HIV/AIDS interventions in the health sector September 2009 Progress report Towards universal access provides a comprehensive global update on progress
More informationProgress on the targets of Millennium Development Goal 6 in central and eastern Europe and central Asia
Progress on the targets of Millennium Development Goal 6 in central and eastern Europe and central Asia 11 October 2011 Moscow, Russian Federation Zsuzsanna Jakab WHO Regional Director for Europe Millennium
More informationSince the start t of the HIV/ 1980 s: 77.3 million people have be. In million people were liv
The HIV/AIDS Epidemic and Sustainable Development tgoals Etienne Karita, MD MSc MSPH Kigali, 8 Nov 018 IV/AIDS Burden Since the start t of the HIV/ V/AIDS epidemic i in the early 1980 s: 77.3 million people
More informationEl futuro del diagnostico de la ITL. en tiempos de crisis. Professor Ajit Lalvani FMedSci Chair of Infectious Diseases
El futuro del diagnostico de la ITL. en tiempos de crisis Taller de TB de Barcelona, Noviembre 2012 Professor Ajit Lalvani FMedSci Chair of Infectious Diseases Department of Respiratory Medicine National
More informationENHANCING AFRICA S PUBLIC HEALTH RESPONSE THROUGH INNOVATION AND PARTNERSHIPS
ENHANCING AFRICA S PUBLIC HEALTH RESPONSE THROUGH INNOVATION AND PARTNERSHIPS Strategic plan for the Africa CDC March 24-25, 2017 The Ebola outbreak underscored the fact that 2 pandemics are not just a
More informationTuberculosis in Alameda County, 2009
Tuberculosis in Alameda County, 29 Alameda County Public Health Department Tuberculosis Overview Tuberculosis (TB) is a communicable disease caused by the bacteria Mycobacterium tuberculosis. TB is spread
More informationGood Health & Well-Being. By Alexandra Russo
Good Health & Well-Being By Alexandra Russo SDG 3 Goal 3 aims to ensure healthy living and promote well-being for all at all ages There are 9 targets associated with SDG 3 The targets encompass a wide
More informationCholera Epidemiological study in the East and Southern Africa region UNICEF ESARO study
Cholera Epidemiological study in the East and Southern Africa region UNICEF ESARO study Presentation for the GTFCC Surveillance Working Group April 16, 2018 Background Cholera burden Cholera epidemics
More informationThe Impact of the Global Economic Crisis on HIV and AIDS. Carlos Avila. 7 December 2009 UNAIDS Geneva
The Impact of the Global Economic Crisis on HIV and AIDS Carlos Avila 7 December 2009 UNAIDS Geneva Outline 1. What the monitoring system is telling us? 2. What are the driving forces? 3. What countries
More informationChildren and AIDS Fourth Stocktaking Report 2009
Children and AIDS Fourth Stocktaking Report 2009 The The Fourth Fourth Stocktaking Stocktaking Report, Report, produced produced by by UNICEF, UNICEF, in in partnership partnership with with UNAIDS, UNAIDS,
More informationTB 2015 burden, challenges, response. Dr Mario RAVIGLIONE Director
TB 2015 burden, challenges, response Dr Mario RAVIGLIONE Director Addis Ababa, Ethiopia 11-13 November 2015 Overview TB basics TB burden & challenges Response: End TB Strategy DAY 1 What is TB? Definition
More informationThe authors assessed drug susceptibility patterns
Drug Resistance Among Tuberculosis Patients, 1991 and 1992 New York City, CYNTHIA R. DRIVER, RN, MPH THOMAS R. FRIEDEN, MD, MPH ALAN B. BLOCH, MD, MPH IDA M. ONORATO, MD All the authors are with the Division
More informationThe Progressive Control Pathway (PCP) for FMD control
The Progressive Control Pathway (PCP) for FMD control Peter de Leeuw, DVM, PhD Senior Veterinary Advisor FAO 1 What is the PCP-FMD? A development tool, with a stepwise approach to improve FMD control in
More informationHealth Issues in the Developing World. Claire-Cecile Cecile Pierre, MD Cambridge Health Alliance November 8, 2004
Health Issues in the Developing World Claire-Cecile Cecile Pierre, MD Cambridge Health Alliance November 8, 2004 Overall Goals Review causes of death in developing world Discuss cases on needs and contributing
More informationApproaches to LTBI Diagnosis
Approaches to LTBI Diagnosis Focus on LTBI October 8 th, 2018 Michelle Haas, M.D. Associate Director Denver Metro Tuberculosis Program Denver Public Health DISCLOSURES I have no disclosures or conflicts
More informationCAPACITY BUILDING TRAINING WORKSHOP ON VIRAL HEPATITIS FOR AFRICAN UNION MEMBER STATES. Cairo, Egypt
المؤسسة اإلفريقية لمرضي الكبد African Liver Patients Association L Association Africaine des Patients atteints d Hépatite Virale CAPACITY BUILDING TRAINING WORKSHOP ON VIRAL HEPATITIS FOR AFRICAN UNION
More informationEssentials of Aggregate System Dynamics Infectious Disease Models. Nathaniel Osgood CMPT 858 FEBRUARY 3, 2011
Essentials of Aggregate System Dynamics Infectious Disease Models Nathaniel Osgood CMPT 858 FEBRUARY 3, 2011 Mathematical Models Link Together Diverse Factors Typical Factors Included Infection Mixing
More informationRepositioning AIDS: The World Bank s Approach to Improved Efficiency and Effectiveness Using HIV Program Science Principles
Repositioning AIDS: The World Bank s Approach to Improved Efficiency and Effectiveness Using HIV Program Science Principles Marelize Gorgens mgorgens@worldbank.org The World Bank s Global HIV/AIDS Program
More informationTUBERCULOSIS IN HEALTHCARE SETTINGS Diana M. Nilsen, MD, FCCP Director of Medical Affairs, Bureau of Tuberculosis Control New York City Department of
TUBERCULOSIS IN HEALTHCARE SETTINGS Diana M. Nilsen, MD, FCCP Director of Medical Affairs, Bureau of Tuberculosis Control New York City Department of Health and Mental Hygiene TODAY S PRESENTATION Epidemiology
More information