AntiTBDrug

The AntiTBDrug intervention class specifies how TB drugs affect individuals in the model. After treatment, individuals may achieve true cure, return to the latent state but quickly relapse, return completely to the latent state, die during treatment, or fail treatment completely. In this intervention, the drug effects are the same regardless of disease status; that is, the effects are the same whether someone has drug-sensitive TB, MDR-TB, or coinfection with HIV.

Although you can specify the rate of each of these state transitions in the campaign file, it’s preferable to specify them in the configuration file using TBHIV_Drug_Params, and then refer to the name of the drug in the campaign file using Drug_Type.

The sum of all daily probabilities for state changes (for example, active to cured) and the total duration of treatment specify the probability that any event occurs. If no event occurs, the individual fails drug treatment.

Note

Parameters are case-sensitive. For Boolean parameters, set to 1 for true or 0 for false. Minimum, maximum, or default values of “NA” indicate that those values are not applicable for that parameter.

EMOD does not use true defaults; that is, if the dependency relationships indicate that a parameter is required, you must supply a value for it. However, many of the tools used to work with EMOD will use the default values provided below.

JSON does not permit comments, but you can add “dummy” parameters to add contextual information to your files.

The table below describes all possible parameters with which this class can be configured. The JSON example that follows shows one potential configuration.

Parameter

Data type

Minimum

Maximum

Default

Description

Example

Cost_To_Consumer

float

0

99999

1

The unit cost per drug (unamortized).

 
{
    "Cost_To_Consumer": 10
}

Disqualifying_Properties

array of strings

NA

NA

[]

A list of IndividualProperty key:value pairs that cause an intervention to be aborted (persistent interventions will stop being distributed to individuals with these values). See NodeProperties and IndividualProperties parameters for more information. Generally used to control the flow of health care access. For example, to prevent the same individual from accessing health care via two different routes at the same time.

 
{
    "Disqualifying_Properties": [
        "InterventionStatus:LostForever"
    ]
}

Dont_Allow_Duplicates

boolean

0

1

0

If an individual’s container has an intervention, set to true (1) to prevent them from receiving another copy of the intervention. Supported by all intervention classes.

 
{
    "Dont_Allow_Duplicates": 0
}

Dose_Interval

float

0

99999

1

The interval between doses, in days.

 
{
    "Dose_Interval": 1
}

Drug_Cmax

float

0

10000

1

The maximum drug concentration that can be used, and is in the same units as Drug_PKPD_C50. Since drug concentrations and C50 values are often specified with different unit systems, these two parameters have been designed to be flexible provided that the units are the same for each. This parameter is used when Durability_Profile is set to CONCENTRATION_VERSUS_TIME.

 
{
    "Durability_Profile": "CONCENTRATION_VERSUS_TIME",
    "Drug_Cmax": 200,
    "Drug_PKPD_C50": 6,
    "Drug_Vd": 1
}

Drug_PKPD_C50

float

0

10000

1

The concentration at which drug killing rates are half of the maximum. Must use the same units as Drug_Cmax. This parameter is used when Durability_Profile is set to CONCENTRATION_VERSUS_TIME.

 
{
    "Durability_Profile": "CONCENTRATION_VERSUS_TIME",
    "Drug_Cmax": 200,
    "Drug_PKPD_C50": 6,
    "Drug_Vd": 1
}

Drug_Type

enum

NA

NA

DOTS

Specifies the name of the drug treatment, such as DOTS or EmpiricTreatment, which can be useful for reporting from the simulation. Possible values are:

  • DOTS

  • DOTSImproved

  • EmpiricTreatment

  • FirstLineCombo

  • SecondLineCombo

  • ThirdLineCombo

  • LatentTreatment

 
{
    "Intervention_Config": {
        "Cost_To_Consumer": 1,
        "Drug_Type": "FirstLineCombo",
        "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
        "Primary_Decay_Time_Constant": 10,
        "Remaining_Doses": 1,
        "TB_Drug_Cure_Rate": 0.1,
        "TB_Drug_Inactivation_Rate": 1e-08,
        "TB_Drug_Resistance_Rate": 1e-09,
        "TB_Drug_Relapse_Rate": 1e-07,
        "Reduced_Transmit": 1,
        "class": "AntiTBDrug"
    }
}

Drug_Vd

float

0

10000

1

The volume of drug distribution. This value is the ratio of the volume of the second compartment to the volume of the first compartment in a two-compartment model, and is dimensionless. This parameter is used when Durability_Profile is set to CONCENTRATION_VERSUS_TIME.

 
{
    "Durability_Profile": "CONCENTRATION_VERSUS_TIME",
    "Drug_Cmax": 200,
    "Drug_PKPD_C50": 6,
    "Drug_Vd": 1
}

Durability_Profile

enum

NA

NA

FIXED_DURATION_CONSTANT_EFFECT

The profile of durability decay. Possible values are:

FIXED_DURATION_CONSTANT_EFFECT

The durability does not decay.

CONCENTRATION_VERSUS_TIME

Conditionally loads the following parameters: Drug_Cmax, Drug_PKPD_C50, and Drug_Vd.

 
{
    "Durability_Profile": "CONCENTRATION_VERSUS_TIME",
    "Drug_Cmax": 200,
    "Drug_PKPD_C50": 6,
    "Drug_Vd": 1
}

Fraction_Defaulters

float

0

1

0

The fraction of individuals who will not finish their drug treatment.

 
{
    "Fraction_Defaulters": 0
}

Intervention_Name

string

NA

NA

AntiTBDrug

The optional name used to refer to this intervention as a means to differentiate it from others that use the same class.

 
{
    "Intervention_Config": {
        "class": "AntiTBDrug",
        "Intervention_Name": "Rifampin treatment"
    }
}

New_Property_Value

string

NA

NA

NA

An optional IndividualProperty key:value pair that will be assigned when the intervention is distributed. See NodeProperties and IndividualProperties parameters for more information. Generally used to indicate the broad category of health care cascade to which an intervention belongs to prevent individuals from accessing care through multiple pathways. For example, if an individual must already be taking a particular medication to be prescribed a new one.

 
{
    "New_Property_Value": "InterventionStatus:None"
}

Primary_Decay_Time_Constant

float

0

1.00E+0

0

The primary decay time constant (in days) of the decay profile.

 
{
    "Primary_Decay_Time_Constant": 180
}

Reduced_Transmit

float

0

1

1

The transmission reduction ratio, or the reduced infectiousness when an individual receives drugs.

 
{
    "Intervention_Config": {
        "Cost_To_Consumer": 1,
        "Drug_Type": "FirstLineCombo",
        "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
        "Primary_Decay_Time_Constant": 10,
        "Remaining_Doses": 1,
        "TB_Drug_Cure_Rate": 0.1,
        "TB_Drug_Inactivation_Rate": 1e-08,
        "TB_Drug_Resistance_Rate": 1e-09,
        "TB_Drug_Relapse_Rate": 1e-07,
        "Reduced_Transmit": 1,
        "class": "AntiTBDrug"
    }
}

Remaining_Doses

integer

0

999999

0

The remaining doses in an intervention; enter a negative number for unlimited doses.

 
{
    "Remaining_Doses": 1
}

Secondary_Decay_Time_Constant

float

0

999999

1

The secondary decay time constant of the durability profile. This parameter is used when Durability_Profile is set to CONCENTRATION_VERSUS_TIME.

 
{
    "Durability_Profile": "CONCENTRATION_VERSUS_TIME",
    "Secondary_Decay_Time_Constant": 730
}

TB_Drug_Cure_Rate

float

0

1

0

The rate of TB clearance per day when an individual is on a drug regimen. This parameter, TB_Drug_Inactivation, TB_Drug_Relapse_Rate, and TB_Drug_Mortality_Rate specify the daily probability of a change in the TB disease state during the course of treatment. The sum of these rates and the total duration of treatment specify the probability that any event occurs. If no event occurs, the individual fails drug treatment.

 
{
    "Actual_IndividualIntervention_Configs": [
        {
            "class": "AntiTBDrug",
            "Cost_To_Consumer": 90,
            "Drug_Type": "FirstLineCombo",
            "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
            "Primary_Decay_Time_Constant": 180,
            "Remaining_Doses": 1,
            "TB_Drug_Cure_Rate": 0.05,
            "TB_Drug_Inactivation_Rate": 0,
            "TB_Drug_Mortality_Rate": 0.00162,
            "TB_Drug_Resistance_Rate": 1e-09,
            "TB_Drug_Relapse_Rate": 0.00223
        }
    ]
}

TB_Drug_Inactivation_Rate

float

0

1

0

The rate of TB inactivation per day when an individual is on a drug regimen. This parameter, TB_Drug_Cure_Rate, TB_Drug_Relapse_Rate, and TB_Drug_Mortality_Rate, specify the daily probability of a change in the TB disease state during the course of treatment. The sum of these rates and the total duration of treatment specify the probability that any event occurs. If no event occurs, the individual fails drug treatment.

 
{
    "Actual_IndividualIntervention_Configs": [
        {
            "class": "AntiTBDrug",
            "Cost_To_Consumer": 90,
            "Drug_Type": "FirstLineCombo",
            "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
            "Primary_Decay_Time_Constant": 180,
            "Remaining_Doses": 1,
            "TB_Drug_Cure_Rate": 0.05,
            "TB_Drug_Inactivation_Rate": 0,
            "TB_Drug_Mortality_Rate": 0.00162,
            "TB_Drug_Resistance_Rate": 1e-09,
            "TB_Drug_Relapse_Rate": 0.00223
        }
    ]
}

TB_Drug_Mortality_Rate

float

0

1

0

The rate of TB mortality per day when an individual is on a drug regimen. This parameter, TB_Drug_Inactivation, TB_Drug_Relapse_Rate, and TB_Drug_Cure_Rate specify the daily probability of a change in the TB disease state during the course of treatment. The sum of these rates and the total duration of treatment specify the probability that any event occurs. If no event occurs, the individual fails drug treatment.

 
{
    "Actual_IndividualIntervention_Configs": [
        {
            "class": "AntiTBDrug",
            "Cost_To_Consumer": 90,
            "Drug_Type": "FirstLineCombo",
            "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
            "Primary_Decay_Time_Constant": 180,
            "Remaining_Doses": 1,
            "TB_Drug_Cure_Rate": 0.05,
            "TB_Drug_Inactivation_Rate": 0,
            "TB_Drug_Mortality_Rate": 0.00162,
            "TB_Drug_Resistance_Rate": 1e-09,
            "TB_Drug_Relapse_Rate": 0.00223
        }
    ]
}

TB_Drug_Relapse_Rate

float

0

1

0

The rate of TB relapse per day when an individual is on a drug regimen. This parameter, TB_Drug_Inactivation, TB_Drug_Cure_Rate, and TB_Drug_Mortality_Rate specify the daily probability of a change in the TB disease state during the course of treatment. The sum of these rates and the total duration of treatment specify the probability that any event occurs. If no event occurs, the individual fails drug treatment.

 
{
    "Actual_IndividualIntervention_Configs": [
        {
            "class": "AntiTBDrug",
            "Cost_To_Consumer": 90,
            "Drug_Type": "FirstLineCombo",
            "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
            "Primary_Decay_Time_Constant": 180,
            "Remaining_Doses": 1,
            "TB_Drug_Cure_Rate": 0.05,
            "TB_Drug_Inactivation_Rate": 0,
            "TB_Drug_Mortality_Rate": 0.00162,
            "TB_Drug_Resistance_Rate": 1e-09,
            "TB_Drug_Relapse_Rate": 0.00223
        }
    ]
}

TB_Drug_Resistance_Rate

float

0

1

0

This parameter determines the daily probability that an individual with drug-sensitive TB will acquire MDR-TB. Only individuals who return to the latent state or fail can acquire MDR-TB.

 
{
    "Actual_IndividualIntervention_Configs": [
        {
            "class": "AntiTBDrug",
            "Cost_To_Consumer": 90,
            "Drug_Type": "FirstLineCombo",
            "Durability_Profile": "FIXED_DURATION_CONSTANT_EFFECT",
            "Primary_Decay_Time_Constant": 180,
            "Remaining_Doses": 1,
            "TB_Drug_Cure_Rate": 0.05,
            "TB_Drug_Inactivation_Rate": 0,
            "TB_Drug_Mortality_Rate": 0.00162,
            "TB_Drug_Resistance_Rate": 1e-09,
            "TB_Drug_Relapse_Rate": 0.00223
        }
    ]
}

{
    "Campaign_Name": "Basic TB Treatment",
    "Events": [
        {
            "class": "CampaignEvent",
            "Event_Name": "AntiTBDrug",
            "Nodeset_Config": {
                "class": "NodeSetAll"
            },
            "Start_Day": 3,
            "Event_Coordinator_Config": {
                "class": "StandardInterventionDistributionEventCoordinator",
                "Number_Distributions": -1,
                "Number_Repetitions": 1,
                "Property_Restrictions": [],
                "Target_Group": "Everyone",
                "Timesteps_Between_Repetitions": 1,
                "Demographic_Coverage": 1.0,
                "Intervention_Config": {
                    "class": "AntiTBDrug",
                    "Primary_Decay_Time_Constant": 180,
                    "Reduced_Transmit": 1,
                    "Remaining_Doses": 1,
                    "Drug_Type": "FirstLineCombo"
                }
            }
        }
    ],
    "Use_Defaults": 1
}