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Related Concept Videos

Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
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Pulmonary Tuberculosis V01:28

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Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
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Comprehensive & Cost Effective Laboratory Monitoring of HIV/AIDS: an African Role Model
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Cost-effectiveness of Low-complexity Screening Tests in Community-based Case-finding for Tuberculosis.

Lukas E Brümmer1,2,3, Ryan R Thompson3, Akash Malhotra3

  • 1Division of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|August 25, 2023
PubMed
Summary
This summary is machine-generated.

Low-complexity tuberculosis (TB) screening tests can improve cost-effectiveness in community-based case-finding. However, these tests must be sensitive, specific, and inexpensive to maximize benefits for TB control.

Keywords:
cost-effectivenessdiagnosticsmathematical modellingscreeningtuberculosis

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Health Economics

Background:

  • Tuberculosis (TB) remains a significant global health challenge, particularly in high-burden regions.
  • Community-based case-finding is crucial for TB control, but its cost-effectiveness can be limited.
  • The role and economic impact of low-complexity screening tests in expanding TB case-finding are not well understood.

Purpose of the Study:

  • To evaluate the cost-effectiveness of different community-based TB case-finding strategies.
  • To compare universal sputum Xpert Ultra testing with strategies incorporating point-of-care C-reactive protein (CRP) or a novel hypothetical screening test.

Main Methods:

  • A microsimulation model was developed to assess three TB case-finding approaches.
  • The model simulated hypothetical populations in India, South Africa, The Philippines, Uganda, and Vietnam, with TB prevalence four times the national estimates.
  • Costs included direct medical costs and treatment expenses, expressed in 2023 US dollars.

Main Results:

  • Universal Xpert Ultra testing was estimated to cost $4.0 million per 100,000 people screened, averting 3200 disability-adjusted life years (DALYs).
  • C-reactive protein (CRP) screening was projected to be more cost-effective per DALY averted ($550-$1500) but averted 44% fewer DALYs.
  • A hypothetical screening test, if optimized for high sensitivity (95%) and specificity (95%) with a low cost ($4.5), could achieve a cost-effectiveness of $390-$940 per DALY averted.

Conclusions:

  • Screening tests can enhance the cost-effectiveness of community-based TB case-finding.
  • The effectiveness of screening tests is contingent upon their sensitivity, specificity, and cost.
  • Optimized screening strategies hold potential for improving TB control efforts in resource-limited settings.