The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.
Is IPT more effective in high-burden settings? Modelling the effect of tuberculosis incidence on IPT impact
Open accessAbstract
SETTING: Isoniazid preventive therapy (IPT) is effective for preventing active tuberculosis (TB), although its mechanism of action is poorly understood and the optimal disease burden for IPT use has not been defined. OBJECTIVE: To describe the relationship between TB incidence and IPT effectiveness. METHODS: We constructed a model of TB transmission dynamics to investigate IPT effectiveness under various epidemiological settings. The model structure was intended to be highly adaptable to uncertainty in both input parameters and the mechanism of action of IPT. To determine the optimal setting for IPT use, we identified the lowest number needed to treat (NNT) with IPT to prevent one case of active TB. RESULTS: We found that the NNT as a function of TB incidence shows a 'U-shape', whereby IPT impact is greatest at an intermediate incidence and attenuated at both lower and higher incidence levels. This U-shape was observed over a broad range of parameter values; the optimal TB incidence was between 500 and 900 cases per 100 000 per year. CONCLUSIONS: TB burden is a critical factor to consider when making decisions about communitywide implementation of IPT. We believe that the total disease burden should not preclude programmatic application of IPT.
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Some countries are exploring alternative drugs or combination therapies for IPT.
“However, some countries are now exploring alternative drugs or combination therapies for IPT [209–211].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [209]
The Discussion mentions specific regimens for multidrug-resistant latent TB only as a hypothetical extension of the model; it does not say that countries are exploring alternative drugs or combination therapies for IPT. Searches for alternative drugs, combination therapies, and country-level exploration found no passage addressing that claim. (LLM, conf=0.72)
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Metadata
- Authors
- Ragonnet, R., Trauer, J. M., McBryde, E. S., Houben, R. M. G. J., Denholm, J. T., Handel, A., & Sumner, T.
- Affiliations
- The Royal Melbourne Hospital (AU)
- London School of Hygiene & Tropical Medicine (GB)
- University of Georgia (US)
- Corresponding author
- Ragonnet, R.
- Venue
- The International Journal of Tuberculosis and Lung Disease
- Published
- 2017-01-01
- Volume
- 21
- Issue
- 1
- Pages
- 60-66
- ISSN
- 1027-3719 (ISSN-L)
- PMC
- PMC5166561
- OpenAlex
- W2561955155
- Cited by
- 31
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 4 · 2021: 1 · 2020: 4 · 2019: 6 · 2018: 7
- FWCI
- 4.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- The International Journal of Tuberculosis and Lung Disease (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- ResearchOnline at James Cook University (James Cook University) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Funders
- Bill and Melinda Gates Foundation (OPP1084276)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV, TB, and STIs Epidemiology
- Physical Sciences › Mathematics › Applied Mathematics › Mathematical and Theoretical Epidemiology and Ecology Models
- Keywords
- isoniazid preventive therapy, tuberculosis incidence, tuberculosis transmission dynamics, number needed to treat, disease burden, U-shaped relationship, tuberculosis prevention
- MeSH terms
- Antitubercular Agents, Humans, Isoniazid, Sensitivity and Specificity, Tuberculosis, World Health Organization, Incidence
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