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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Atun RA, McKee M, Drobniewski F and Coker R ( 2005a ). Analysis of how health system context influences HIV control: case studies from the Russian Federation . Bltn of the WHO 83 : 730 – 738 .
Atun RA, Lebcir RM, Drobniewski F and Coker RJ ( 2005b ). Impact of an effective multidrug-resistant tuberculosis control programme in the setting of an immature HIV epidemic: system dynamics simulation model . Int J of STD and AIDS 16 : 560 – 570 .
Balabanova Y, Drobniewski F, Fedorin I, Zakharova S, Nikolayevskyy V, Atun R and Coker R ( 2006 ). The Directly Observed Therapy Short-Course (DOTS) strategy in Samara Oblast, Russian Federation . Respir Res 7 : 44 .
Barlas Y ( 1996 ). Formal aspects of model validity and validation in system dynamics . Syst Dynam Rev 12 : 183 – 210 .
Brailsford SC, Lattimer VA, Tarnaras R and Turnbull JC ( 2004 ). Emergency and on-demand health care: Modelling a large complex system . J Opl Res Soc 55 : 34 – 42 .
Coetzee D, Hilderbrand K, Goemaere E, Matthys F and Boelaert M ( 2004 ). Integrating tuberculosis and HIV care in the primary care setting in South Africa . Trop Med Int Health 9 : 11 – 15 .
Coker RJ ( 2004 ). Multidrug-resistant tuberculosis: public health challenges . Trop Med Int Health 9 : 25 – 40 .
Coker RJ, Dimitrova B, Drobniewski F, Samyshkin Y, Balabanova Y, Kuznetsov S, Fedorin I, Melentsiev A, Marchenko G, Zakharova S and Atun R ( 2003 ). Tuberculosis control in Samara Oblast, Russia: Institutional and regulatory environment . Int J Tuberc Lung D 7 : 920 – 932 .
Currie CSM, Williams BG, Cheng RCH and Dye C ( 2003 ). Tuberculosis epidemics driven by HIV: Is prevention better than cure? AIDS 17 : 2501 – 2508 .
Dangerfield BC ( 1999 ). System dynamics applications to European health care issues . J Opl Res Soc 50 : 345 – 353 .
Dangerfield BC, Fang Y and Roberts CA ( 2001 ). Model-based scenarios for the epidemiology of HIV/AIDS: The consequences of highly active antiretroviral therapy . Syst Dynam Rev 17 : 119 – 150 .
Dangerfield BC and Roberts CA ( 1999 ). Optimisation as a statistical estimation tool: An example in estimating the AIDS treatment free incubation period distribution . Syst Dynam Rev 15 : 273 – 291 .
Drobniewski FA, Atun R, Fedorin I, Bikov A and Coker R ( 2004 ). The ‘bear trap': The colliding epidemics of tuberculosis and HIV in Russia . Int J of STD & AIDS 15 : 641 – 646 .
Drobniewski FA, Balabanova Y, Zakamova E, Nikolayevskyy V and Fedorin I ( 2007 ). Rates of latent tuberculosis in health care staff in Russia . Plos Medicine 4 : 273 – 279 .
Floyd K, Hutubessy R, Samyshkin Y, Korobitsyn A, Fedorin I, Volchenkov GB, Kazeonny B, Coker RJ, Drobniewski F, Jakubowiak W, Shilova M and Atun RA ( 2006 ). Health systems efficiency in the Russian Federation: Tuberculosis control . Bltn of WHO 84 : 43 – 51 .
Garnett GP and Gazzard B ( 2008 ). Risk of HIV transmission in discordant couples . Lancet 372 : 270 – 271 .
Grassly NC, Lowndes CM, Rhodes T, Judd A, Renton A and Garnett PG ( 2003 ). Modelling emerging HIV epidemics: The role of injecting drug use and sexual transmission in the Russian Federation, China and India . Int J Drug Policy 14 : 25 – 43 .
Griffiths JD, Lawson ZF and Williams JE ( 2006 ). Modelling treatment effects in the HIV/AIDS epidemic . J Opl Res Soc 57 : 1413 – 1424 .
Hamers FF and Downs AM ( 2003 ). HIV in central and eastern Europe . Lancet 361 : 1035 – 1044 .
Homer JB and Hirsch GB ( 2006 ). System dynamics modeling for public health: Background and opportunities . Am J Public Health 96 : 452 – 458 .
Lasry A, Zaric GS and Carter MW ( 2007 ). Multi-level resource allocation for HIV prevention: A model for developing countries . Eur J Opl Res 180 : 786 – 799 .
May RM, Anderson RM and Irwin ME ( 1988 ). The transmission dynamics of human immunodeficiency virus (HIV) . Phil Trans R Soc Lond. Serie B, Biological Science 321 : 565 – 607 .
Rauner MS, Braislford SC and Flessa S ( 2005 ). Use of discrete-event simulation to evaluate strategies for the prevention of mother-to-child transmission of HIV in developing countries . J Opl Res Soc 56 : 222 – 233 .
Rhodes T, Ball A, Stimson G, Kobyshcha Y, Fitch C, Pokrovsky V, Bezruchenko-Novachuk M, Burrows D, Renton A and Andrushchak L ( 1999 ). HIV infection associated with drug injecting in the newly independent states, eastern Europe . The social and economic context. Addiction 94 : 1323 – 1336 .
Rhodes T, Lowndes C, Judd A, Mikhailova LA, Sarang A, Rylkov A, Tichonov M, Lewis K, Ulyanova N, Alpatova T, Karavashkin V, Khutorskoy M, Hickman M, Parry JV and Rention A ( 2002 ). Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City . Russian Federation: Implications for HIV prevention. AIDS 16 : F25 – F31 .
Shaboltas AV, Toussova OV, Hoffman IF, Heimer R, Verevochkin SV, Ryder RW, Khoshnood K, Perdue T, Masse BR and Kozlov AP ( 2006 ). HIV prevalence, sociodemographic, and behavioural correlates and recruitment methods among injection drug users in St. Petersburg, Russia . J Acq Immun Def Synd 41 : 657 – 663 .
Sterman JD ( 2000 ). Business Dynamics. Systems Thinking and Modeling for a Complex World . Mc-Graw Hill: Singapore .
Vynnycky E and Fine PEM ( 2000 ). Lifetime risks, incubation period, and serial interval of tuberculosis . Am J Epidemial 152 : 247 – 263 .
Walensky RP, Paltiel AD, Losina E, Mercincavage LM, Shackman BR, Sax PE, Weinstein MC and Freedberg KA ( 2006 ). The survival benefits of AIDS treatment in the United States . J Inf Dis 194 : 11 – 19 .
Williams BG and Dye C ( 2003 ). Antiretroviral drugs for tuberculosis control in the era of HIV/AIDS . Science 301 : 1535 – 1537 .
Wilson DP, Law MG, Grulich AE, Cooper DA and Kaldor JM ( 2008 ). Relation between HIV viral load and infectiousness: A model based analysis . Lancet 372 : 314 – 320 .
World Health Organization ( 2005 ). Treating 3 million by 2005: Making It Happen: The WHO Strategy: The WHO and UNAIDS Global Initiative to Provide Antiretroviral Therapy to 3 million People with HIV/AIDS in Developing Countries by the End of 2005 . World Health Organization: Geneva .
World Health Organization ( 2007 ). Country Profile: Russian Federation. World Health Organization: Geneva .
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lebcir, R., Atun, R. & Coker, R. System Dynamic simulation of treatment policies to address colliding epidemics of tuberculosis, drug resistant tuberculosis and injecting drug users driven HIV in Russia. J Oper Res Soc 61, 1238–1248 (2010). https://doi.org/10.1057/jors.2009.90
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1057/jors.2009.90