Journal of the Operational Research Society

, Volume 61, Issue 8, pp 1238–1248 | Cite as

System Dynamic simulation of treatment policies to address colliding epidemics of tuberculosis, drug resistant tuberculosis and injecting drug users driven HIV in Russia

Case-oriented Paper

Abstract

The explosive increase in the number of people infected with tuberculosis (TB), multi drug resistant tuberculosis (MDRTB), and injecting drug users (IDU) HIV/AIDS has become a serious public health challenge in Russia. The World Health Organization is recommending policies including simultaneous use of highly active antiretroviral therapy (HAART) to treat HIV/AIDS and second line drugs to treat MDRTB. We developed a System Dynamics simulation model to represent the dynamic transmission of TB, MDRTB and human immunodeficiency virus (HIV). The model simulated scenarios regarding MDRTB cure rate and HAART coverage, that is the HIV/AIDS population covered by HAART. The results over a 20-year period indicate that reduction in TB and HIV-associated TB deaths would be negligible for HAART coverage up to 50%. The reduction is only significant for HAART coverage of 70% and above. Similarly, high MDRTB cure rate reduces significantly deaths from TB and MDRTB and this reduction is more important as the HAART coverage is increased.

Keywords

health service HIV tuberculosis HAART System Dynamics Russia 

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Copyright information

© Operational Research Society 2009

Authors and Affiliations

  1. 1.University of HertfordshireHatfieldUK
  2. 2.Imperial College LondonLondonUK
  3. 3.London School of Hygiene and Tropical MedicineLondonUK

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