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Prevention of disease

Prevention of disease refers to the ability of the vaccine to protect individuals from becoming sick from the tuberculosis (TB) bacteria after exposure to it. It does not necessarily prevent a person from getting infected with the TB bacteria.

Advancing evidence-informed in-country decision-making for new TB vaccine introduction: A responsive and integrated vaccine modelling approach from India

As new TB vaccines move into late-stage development, it is imperative for high-burden countries like India to ensure timely and effective evidence-generation to inform decision-making and accelerate vaccine development and introduction. To enable this, an in-country vaccine mathematical modelling effort has been initiated in India.

Modelling to estimate the health impact of novel tuberculosis vaccines on TB burden in people living with HIV

This project will inform tuberculosis (TB) prevention efforts by estimating the health impact of novel tuberculosis vaccines on TB burden in people living with HIV (PLHIV) using a novel Mycobacterium tuberculosis transmission model. HIV confers the largest relative risk of TB, and new TB vaccines could be an important tool to prevent TB; however, modelling studies have not systematically investigated how new vaccines will affect TB burden in PLHIV. In stage 1 of this project, we aim to investigate TB vaccine impact in PLHIV where vaccine product characteristics and delivery vary by recipient HIV status. In stage 2, we aim to quantify how complex vaccine targeting strategies and incorporating additional granularity in HIV/AIDS natural history might affect vaccine impact estimates in PLHIV

FAST-TB MOD

FAST-TB population and cost-effectiveness modelling core: This project will accelerate tuberculosis (TB) research translation by using mathematical modelling to address key priority questions as part of FAST TB, linking an expanded state-of-the-art modelling framework with country level data and cross consortium communication around new TB treatment regimens, diagnostics and other interventions.

Creating evidence to support tuberculosis (TB) national and global decision-makers in reducing the global burden of TB

In strong collaboration, we (India, South Africa, Brazil, Indonesia, UK) will create evidence to strengthen capacity and sustainably support high tuberculosis (TB) burden countries (HBC) and global decision-makers in reducing the global burden of TB, by using modelling tools to address key questions on drug-resistant (DR-)TB, new TB vaccines and other interventions, and extend and apply a state-of-the-art TB model, to estimate the relative health, cost-effectiveness, and budget impact, of new and existing interventions, as well as their optimal combination.

Prep4TBVax

New TB vaccines are likely to be crucial in addressing the ongoing TB pandemic. With multiple promising vaccine candidates in the pipeline and the earliest availability of a candidate expected by 2028, it is of outmost importance that once available, the vaccine can be implemented rapidly and effectively. Limited research has looked at the delivery strategies available to provide a new TB vaccine to beneficiaries and therefore, this study assesses the acceptability and feasibility of delivery strategies for the vaccine candidates M72/AS01e and MTBVAC in Ethiopia, Nigeria, and Tajikistan.

Potential implications of reduced tuberculosis vaccine efficacy in those with undernutrition on overall vaccine impact in India

Nutritional status is a leading risk factor for tuberculosis (TB). In India up to half of all TB episodes are attributed to undernutrition. Given the impact of nutrition on the immune system, vaccine characteristics such as efficacy and duration of protection could vary depending on nutritional status. Therefore, previous vaccine impact estimates may be overestimated. We re estimated vaccine impact in India with reduced efficacy with undernutrition

Evaluating infectious disease prevention over the long term: implications of analytic horizon and scenario choices

A lifetime time horizon is conventional for cost-effectiveness analysis, but not routine for transmission-dynamic modeling given uncertainty in epidemiological dynamics and high computational costs. We demonstrate how choices about time horizon and analytic scenarios can influence cost-effectiveness estimates, using a case study of novel tuberculosis (TB) vaccine introduction.
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