Houben R M G J, Lalli M, Sumner T, Hamilton M, Pedrazzoli D, Bonsu F, Hippner P, Pillay Y, Kimerling M, Ahmedov S, Pretorius C, White R G
TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
BMC Med. 2016 Mar 24;14:56. doi: 10.1186/s12916-016-0608-4.
Tuberculosis (TB) is the leading cause of death from infectious disease worldwide, predominantly affecting low- and middle-income countries (LMICs), where resources are limited. As such, countries need to be able to choose the most efficient interventions for their respective setting. Mathematical models can be valuable tools to inform rational policy decisions and improve resource allocation, but are often unavailable or inaccessible for LMICs, particularly in TB. We developed TIME Impact, a user-friendly TB model that enables local capacity building and strengthens country-specific policy discussions to inform support funding applications at the (sub-)national level (e.g. Ministry of Finance) or to international donors (e.g. the Global Fund to Fight AIDS, Tuberculosis and Malaria).TIME Impact is an epidemiological transmission model nested in TIME, a set of TB modelling tools available for free download within the widely-used Spectrum software. The TIME Impact model reflects key aspects of the natural history of TB, with additional structure for HIV/ART, drug resistance, treatment history and age. TIME Impact enables national TB programmes (NTPs) and other TB policymakers to better understand their own TB epidemic, plan their response, apply for funding and evaluate the implementation of the response.The explicit aim of TIME Impact's user-friendly interface is to enable training of local and international TB experts towards independent use. During application of TIME Impact, close involvement of the NTPs and other local partners also builds critical understanding of the modelling methods, assumptions and limitations inherent to modelling. This is essential to generate broad country-level ownership of the modelling data inputs and results. In turn, it stimulates discussions and a review of the current evidence and assumptions, strengthening the decision-making process in general.TIME Impact has been effectively applied in a variety of settings. In South Africa, it informed the first South African HIV and TB Investment Cases and successfully leveraged additional resources from the National Treasury at a time of austerity. In Ghana, a long-term TIME model-centred interaction with the NTP provided new insights into the local epidemiology and guided resource allocation decisions to improve impact.
结核病是全球传染病致死的主要原因，主要影响资源有限的低收入和中等收入国家（LMICs）。因此，各国需要能够为其各自的情况选择最有效的干预措施。数学模型可以成为为合理的政策决策提供信息和改善资源分配的宝贵工具，但低收入和中等收入国家往往无法获得或难以获取这些模型，尤其是在结核病领域。我们开发了“结核病影响模型（TIME Impact）”，这是一个用户友好型的结核病模型，能够促进当地能力建设，并加强针对特定国家的政策讨论，为（次）国家层面（如财政部）或国际捐助者（如全球抗击艾滋病、结核病和疟疾基金）的资助申请提供信息。“结核病影响模型（TIME Impact）”是嵌套在“结核病综合模型环境（TIME）”中的一种流行病学传播模型，“结核病综合模型环境（TIME）”是一组可在广泛使用的Spectrum软件中免费下载的结核病建模工具。“结核病影响模型（TIME Impact）”反映了结核病自然史的关键方面，并增加了关于艾滋病毒/抗逆转录病毒治疗、耐药性、治疗史和年龄的结构。“结核病影响模型（TIME Impact）”使国家结核病规划（NTPs）和其他结核病政策制定者能够更好地了解本国的结核病疫情、规划应对措施、申请资金并评估应对措施的实施情况。“结核病影响模型（TIME Impact）”用户友好型界面的明确目标是使当地和国际结核病专家能够接受培训，实现独立使用。在应用“结核病影响模型（TIME Impact）”的过程中，国家结核病规划（NTPs）和其他当地合作伙伴的密切参与也能增进对建模方法、假设以及建模所固有的局限性的关键理解。这对于在国家层面广泛认可建模数据输入和结果至关重要。反过来，它会激发讨论并促使对当前证据和假设进行审查，总体上加强决策过程。“结核病影响模型（TIME Impact）”已在多种情况下得到有效应用。在南非，它为首个南非艾滋病毒和结核病投资案例提供了信息，并在财政紧缩时期成功从国家财政部撬动了更多资源。在加纳，与国家结核病规划（NTPs）进行的以长期“结核病综合模型环境（TIME）”为中心的互动，为当地流行病学提供了新的见解，并指导了资源分配决策以提高影响力。
