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Related Experiment Videos

School-based screening for tuberculous infection. A cost-benefit analysis

J C Mohle-Boetani1, B Miller, M Halpern

  • 1Disease Control and Prevention Division, County of Santa Clara Public Health Department, San Jose, CA, USA.

JAMA
|August 23, 1995
PubMed
Summary

Targeted tuberculosis screening in schools is more cost-effective than screening all students. This approach prevents more cases of tuberculosis with significant cost savings.

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Economics

Background:

  • Tuberculosis (TB) remains a public health concern, necessitating effective screening strategies in schools.
  • Defining high-risk populations for TB infection is crucial for resource allocation.

Purpose of the Study:

  • To compare the effectiveness and cost-efficiency of two tuberculin screening strategies in schoolchildren: screening all students versus targeted screening of high-risk groups.
  • To evaluate the economic impact of each screening approach on tuberculosis prevention.

Main Methods:

  • Decision analysis, cost-effectiveness analysis, and cost-benefit analysis were employed.
  • The study population included students from urban and rural counties.
  • Key outcome measures included tuberculosis cases prevented, net costs, and benefit-cost ratios.

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Main Results:

  • Targeted screening prevented 84.9 cases per 10,000 children, significantly more than the screen-all strategy (14.9 cases per 10,000).
  • The screen-all strategy incurred higher costs with a benefit-cost ratio of 0.58, while targeted screening resulted in net savings (benefit-cost ratio of 1.2).
  • Screening all children was only cost-saving if the reactor rate exceeded 20%.

Conclusions:

  • Targeted screening of schoolchildren is substantially more cost-effective and efficient for tuberculosis prevention compared to mass screening.
  • This study supports the implementation of targeted screening to optimize public health resources for tuberculosis control.