Nutritional Interventions to End Tuberculosis among persons with HIV in India (NUTRIENT-India)

通过营养干预措施消除印度艾滋病毒感染者的结核病（NUTRIENT-India）

• 批准号: 10619776
• 负责人: Pranay Sinha
• 金额: $ 12.78万
• 依托单位: BOSTON MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-20 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619776
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adult; Age; Alcohol consumption; Anti-Retroviral Agents; Bayesian Modeling; Body mass index; CD4 Lymphocyte Count; Calibration; Categories; Cessation of life; Characteristics; Clinical; Cost Analysis; Cost Effectiveness Analysis; Country; Data; Diabetes Mellitus; Dietary Intervention; Economic Policy; Effectiveness; Epidemic; Food; Funding; Future; Goals; HIV; HIV Seronegativity; HIV/TB; Health Policy; Health Surveys; Healthcare; Incentives; Incidence; India; Individual; Intervention; Investments; K-Series Research Career Programs; Language; Learning; Literature; Low Prevalence; Malnutrition; Mathematics; Mentorship; Modeling; Nutritional; Nutritional Study; Nutritional status; Observational Study; Patients; Persons; Policies; Policy Maker; Population; Prevalence; Public Health; Publishing; Research Personnel; Resolution; Resources; Risk Estimate; Risk Factors; Risk Reduction; Smoking; South Africa; Surveys; Treatment Failure; Treatment outcome; Tuberculosis; age group; antiretroviral therapy; clinical decision-making; cohort; comorbidity; cost; cost effective; cost effectiveness; cost estimate; cost-effectiveness ratio; data streams; disability-adjusted life years; economic evaluation; falls; health economics; improved; incremental cost-effectiveness; insight; interest; markov model; mathematical model; models and simulation; modifiable risk; mortality; multidisciplinary; novel; nutrition; nutritional supplementation; pandemic disease; programs; prospective; sex; systematic review; transmission process

PROJECT SUMMARY India has the third-highest number of persons with HIV. One-quarter of deaths among persons with HIV are due to TB. Undernutrition is the leading risk factor for TB in India. TB transmission from HIV-negative persons likely fuels the TB epidemic among Indian persons with HIV. I hypothesize that population-scale nutritional interventions would reduce TB incidence and mortality among persons with and without HIV. I also hypothesize that, in an Indian context, in-kind nutritional supplementation would be more cost-effective than cash transfers. Models allow us to generate representations of real-world problems in mathematical language which can be used to gain insights and to make projections. The proposed Nutritional Interventions to End Tuberculosis among persons with HIV in India (NUTRIENT-India) study will have the following aims: 1. Quantify the long-term impact of population-scale nutritional interventions on TB incidence and mortality among persons with and without HIV in the Indian state of Tamil Nadu using a microsimulation model 2. Estimate the impact and cost-effectiveness of a variety of nutritional interventions to decrease TB incidence & mortality among persons with and without HIV For aim 1, we will develop the microsimulation model and validate it. We will then calibrate the model using data from national health surveys and primary data from the ongoing TB Learning the Impact of Nutrition (LION) study of nutritional interventions. For aim 2, we will synthesize evidence on the impact of cash transfers and in-kind transfers on nutritional status of recipients. Next, we will adapt an existing Markov model to simulate three different nutritional interventions: 1) 2600 Kilocalories (Kcal)/d of food, 750 Kcal/d of food, and Rs 500/month cash transfer. We will obtain cost estimates from the TB-LION study and NTEP programmatic costs. After calibrating the model using data from TB-LION and the Regional Prospective Observational Research on Tuberculosis (RePORT)- India consortium, we will conduct cost-effectiveness analysis of the three different nutritional interventions. The NUTRIENT-India study will help quantify the long-term impact of nutritional interventions on TB incidence and mortality among persons with and without TB in India, The study will also define the most cost- effective nutritional interventions in the Indian context. Thus, it will inform policymakers on why they must address this critical TB risk factor that keeps TB entrenched in India and how they can intervene while making maximal use of available resources.

项目摘要 印度是艾滋病毒的人数第三高。艾滋病毒患者中的四分之一死亡 是由于结核病。营养不良是印度结核病的主要危险因素。来自HIV阴性的结核病传播 人们可能会在印​​度艾滋病毒患者中加剧结核病流行。我假设人口规模 营养干预措施将降低和没有艾滋病毒的人的结核病发生率和死亡率。我也是 假设在印度背景下，内心营养补充将比 现金转移。 模型使我们能够在数学语言中生成现实世界中问题的表示 用于获得见解并进行预测。提议的营养干预措施以结束结核病 在印度艾滋病毒（印度营养）研究中，将具有以下目的： 1。量化人口规模营养干预对结核病发生率和死亡率的长期影响 在印度泰米尔纳德邦有和没有艾滋病毒的人中，使用微仿真模型 2。估计各种营养干预措施的影响和成本效益以减少结核病 患有和没有艾滋病毒的人的发病率和死亡率 对于AIM 1，我们将开发微仿真模型并验证它。然后，我们将使用 来自国家卫生调查的数据以及正在进行的结核病学习营养影响的主要数据 （狮子）营养干预措施的研究。对于AIM 2，我们将综合有关现金影响的证据 转移和实物转移接受者的营养状况。接下来，我们将调整现有的马尔可夫模型 模拟三种不同的营养干预措施：1）食物2600千瓦（KCAL）/d，食物750 kcal/d 500卢比/月现金转帐。我们将从TB-LION研究和NTEP编程中获得成本估算 费用。使用TB-LION和区域前瞻性观测的数据校准模型后 结核病研究（报告） - 印度财团，我们将对 三种不同的营养干预措施。 营养 - 印度研究将有助于量化营养干预对结核病的长期​​影响 在印度，有和没有结核病患者的发病率和死亡率，该研究还将定义最大的成本 - 在印度背景下的有效营养干预措施。因此，它将告知决策者为什么他们必须 解决这个关键的结核病风险因素，该因素使印度的结核病根深蒂固，以及如何在制作时进行干预 最大使用可用资源。