Publications by authors named "M X Rangaka"
Effectiveness of the primary Bacillus Calmette-Guérin vaccine against the risk of Mycobacterium tuberculosis infection and tuberculosis disease: a meta-analysis of individual participant data.
Lancet Microbe
December 2024
Background: Tuberculosis vaccine trials using disease as the primary endpoint are large, time consuming, and expensive. An earlier immunological measure of the protection against disease would accelerate tuberculosis vaccine development. We aimed to assess whether the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine for prevention of Mycobacterium tuberculosis infection was consistent with that for prevention of tuberculosis disease.
View Article and Find Full Text PDFCommunity-based active case finding (ACF) for tuberculosis (TB) involves an offer of screening to populations at risk of TB, oftentimes with additional health promotion, community engagement and health service strengthening. Recently updated World Health Organization TB screening guidelines conditionally recommend expanded offer of ACF for communities where the prevalence of undiagnosed pulmonary TB is greater than 0.5% among adults, or with other structural risk factors for TB.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluates the cost and effectiveness of new skin-based tests and blood-based assays for tuberculosis in high-burden countries like India and Brazil.
- Results show that Diaskintest is more cost-effective than the traditional PPD-tuberculin test (TST) for diagnosing TB, with costs of $22.6 in Brazil and $41.0 in India per correctly diagnosed case.
- While Diaskintest is cheaper, TSPOT.TB blood test is more effective despite its higher cost, with an incremental cost-effectiveness ratio of $74 in India and $55 in Brazil.
Article Synopsis
- The current tests for identifying TB infection include the Tuberculin Skin Test (TST) and interferon-gamma release assays (IGRA), but access and implementation issues limit their use.
- Novel skin tests such as Diaskintest and C-TST show potential for better scalability and accuracy, though evidence on their economic impact is still lacking.
- Systematic reviews indicated that while costs for TBST were generally lower than TST and IGRA, there is limited high-quality evidence for TBST, and the existing studies on TST and IGRA lean towards high-income settings without clear economic consensus.