Cost-Effectiveness of Community-Based Active Case Finding Strategy for Tuberculosis: Evidence From Shenzhen, China

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• Active case finding (ACF) shows promise for early tuberculosis (TB) detection.
• Evidence on ACF cost-effectiveness in low- and middle-income countries is limited.
• This study assesses the cost-effectiveness of community-based ACF in Shenzhen, China.

Purpose of the Study:

• To evaluate the cost-effectiveness of community-based active case finding (ACF) for tuberculosis.
• To compare ACF strategies with passive case finding (PCF).

Main Methods:

• Markov model-based decision analysis from a societal perspective.
• Analysis over a 20-year horizon on a dynamic cohort.
• Comparison of passive case finding (PCF), basic ACF, and advanced ACF strategies.

Main Results:

• Basic and advanced ACF reduced active TB cases by 6.8 and 10.2 per 100,000 population, respectively.
• Incremental cost-effectiveness ratios (ICERs) were ¥14,757 and ¥8,217 per quality-adjusted life-year for basic and advanced ACF.
• Both ACF strategies demonstrated cost-effectiveness below the established threshold.

Conclusions:

• Community-based ACF targeting symptomatic individuals is a cost-effective tuberculosis screening strategy.
• ACF offers significant public health benefits in tuberculosis-endemic regions.
• Implementation of similar ACF strategies for symptomatic populations is recommended.