From 1-4 June 2010 the 2nd TB conference was held in Durban. It might be better to rename the conference to HIV/TB conference, as most presentations discussed TB (occurrence, diagnosis, treatment, prognosis) in relation to/combination with HIV. In this Quarterly one of the main articles discusses whether antiretroviral therapy (ART) will help, and to what extend, in lowering TB incidence. Furthermore, one of the short items focuses on monitoring the TB/HIV co-epidemic, and another on the evidence for recommending initiation of ART treatment for TB patients while on therapy.
At the conference there was just one presentation focussing on mathematical modelling (from a SACEMA affiliate), although in one of the sessions it was highlighted that e.g. in order to assess the impact of treatment scale-up on the co-epidemic, a modelling exercise should be conducted.
Bewketu Teshale Bekele, PhD student at SACEMA, was presenting preliminary results of a study aiming to indicate which age group should be targeted in order to make the “test-and-treat” strategy as cost-effective as possible. He discussed an age-and sex-structured mathematical model for HIV-TB co-infection that was developed to estimate the number of HIV and TB cases that could be prevented by this strategy. Furthermore, he presented the differences in cost-effectiveness of an universal test-and-treat strategy versus an age-group specific strategy, over a time window of 5 years (2010-2015). It turned out that targeting women and men aged 25-40 years is the most cost-effective targeting strategy to reduce both HIV and TB incidence in the society. So intensified HIV testing and early initiation of ART for this group would optimise the cost-effectiveness of applying the test-and-treat strategy in South Africa.
Coming back to this issue of the Quarterly, another main article focuses on capacity building for epidemiological modelling, including an explanation of the importance of meaningful statistical modelling in public health. And a third article discusses the Zibambele programme – a unique programme in which job creation is combined with poverty alleviation, and hence contributes to the battle against HIV/AIDS and TB.
Last, but certainly not least, the new director of SACEMA is announced: Dr. Alex Welte.
- Bekele B, Delva W, Pretorius C, Williams B. Optimal age-targeting of early HIV treatment to reduce the incidence of HIV and TB in South Africa. 2nd TB conference, 1-4 June 2010, Durban.