Table 1– Model parameters: values and sources#
ParameterBase case valueRange used in sensitivity analysisSource
Starting age years3618–60Estimated based on cost surveys
TB-related mortality rates %
 Drug-susceptible or mono/polyresistant TB
  Initial Std/EMB initial42–8WHO [27]
  Retreat Std/Str retreat/MDR Std74–11WHO [27]
 RMP-resistant/MDR-TB
  Non-MDR-regimen3330–40Assumed same as untreated TB [28]
  MDR Std119–13Johnston et al. [29]
Other mortality rates
 Untreated TB %3330–40Rieder [28]
 Non-TB-related mortality %Age-specificAge-specificUsed WHO life table for Ecuador [30]
 Mortality rate if blind3.5× age-specific mortality rate3.5× age-specific mortality rateRemme [31]
Probability of EMB-induced blindness %
 Initial Std0.00.0EMB in first 2 months assumed no blindness
 EMB initial/retreat Std/Str retreat  (EMB for 6–8 months)0.230–0.61Ezer et al. [14]
 MDR Std (EMB for 24 months)0.460–0.99Assumed double the risk from retreatment due to longer treatment duration
Treatment default rate+ %
 Drug-susceptible or mono/polyresistant TB
  All initial regimens (6 months)84–15WHO [27]
  All 8-month retreatment regimens154–30WHO [27]
  MDR treatment14.711.2–19.0Assumed same as MDR-TB [29]
 RMP-resistant/MDR-TB
  Non-MDR-regimen0.00.0Assumed that patients would only die, fail or be spontaneously cured
  MDR Std14.711.2–19.0Johnston et al. [29]
Treatment failure rate %
 Drug-susceptible TB
  Any regimen0.30.1–0.4Menzies et al. [32]
 Mono/polyresistant TB
  Initial Std/EMB initial2.80.7–14.7Menzies et al. [32]
  Retreat Std7.40–15.1Menzies et al. [3]
  Str retreat3.70–15.1Assumed half the rate of first-line retreatment [3]
  MDR Std0.40–1.5Estimated from Menzies et al. [3]
 RMP-resistant/MDR-TB
  Non-MDR-regimen4235–45Assumed that patients could only die or be spontaneously cured, and the remainder failed [28, 33]
  MDR Std85–11Johnston et al. [29]
Probability of relapse %
 Drug-susceptible TB
  Any regimen3.72.8–4.7Menzies et al. [32]
 Mono/polyresistant TB
  Initial Std/EMB initial11.46.5–16.2Menzies et al. [32]
  Retreat Std4.64.0–14.5Menzies et al. [3]
  Str retreat2.32.0–14.5Assumed half the rate of first-line retreatment [3]
  MDR Std2.60–7.9Estimated from Menzies et al. [3]
 RMP-resistant/MDR-TB
  Non-MDR-regimen2.51.3–2.5Reported relapse rate among untreated TB cases who had spontaneous cures [33]
  MDR Std2.04.0–14.5Johnston et al. [29]
Probability of acquired INH monoresistant TB  among treatment failures %
 Drug-susceptible TB
  Initial Std44.2Calculated using data from Menzies et al. [32]
  EMB initial/retreat Std22.1Assumed half the rate of the initial standardised regimen [32]
  Str retreat/MDR Std0.00.0No INH in regimen
Probability of acquired INH monoresistant TB  among those who default/relapse %
 Drug-susceptible TB
  Initial Std3.0Calculated using data from Menzies et al. [32]
  EMB initial/retreat Std1.5Assumed half the rate of initial standardised regimen [32]
  Str retreat/MDR Std0.00.0No INH in regimen
Probability of acquired RMP-resistant/MDR-TB  among treatment failures %
 Drug-susceptible TB
  Initial Std17.3Calculated using data from Menzies et al. [32]
  EMB initial/retreat Std8.7Assumed half the rate of initial standardised regimen [32]
  Str retreat/MDR Std0.00.0No INH in regimen
 Mono/polyresistant TB
  Initial Std85.7Calculated from data in Menzies et al. [3]
  EMB initial/retreat Std42.9Assumed half the rate of initial standardised regimen [3]
  Str retreat21.5Assumed half the rate of first-line retreatment [3]
  MDR Std0.00.0No INH or RMP in regimen
Probability of acquired RMP-resistant/MDR-TB  among those who default/relapse %
 Drug-susceptible TB
  Initial Std2.3Calculated from data in Menzies et al. [32]
  EMB initial/retreat Std1.15Assumed half the rate of initial regimen [32]
  Str retreat/MDR Std0.00.0No INH or RMP in regimen
 Mono/polyresistant TB
  Initial Std8.8Calculated from data in Menzies et al. [3]
  EMB initial/retreat Std4.4Assumed half the rate of initial regimen [3]
  Str retreat2.2Assumed half the rate of first-line retreatment [3]
  MDR Std0.00.0No INH or RMP in regimen
Cure rate after treatment default %
 Drug-susceptible or mono/polyresistant TB6225–70Chee et al. [34]
  • TB: tuberculosis; Std: standardised; EMB: ethambutol; Str retreat: strengthened retreatment; MDR: multidrug-resistant; RMP: rifampicin; WHO: World Health Organization; INH: isoniazid. #: all probabilities are based on end-of-treatment outcomes unless otherwise noted; : we assumed that patients with MDR-TB not treated with the standardised MDR regimen experience only three treatment outcomes, fail, die or spontaneously cured; 0% of MDR-TB patients default; +: treatment default rates include patients who default treatment and those who transfer out. We assumed that treatment outcomes of transfers-out were equivalent to those of default [35].