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Costo-efectividad de la quimioterapia para la tuberculosis pulmonar en tres países del África subsahariana
C J Murray1, E DeJonghe, H J Chum
1Center for Population Studies, Harvard University, Cambridge, Massachusetts 02138.
Lancet (London, England)
|November 23, 1991
Resumen
Los programas de quimioterapia para la tuberculosis pulmonar en los países en desarrollo son rentables. La quimioterapia ambulatoria de corto curso ofrece un valor significativo, ahorrando años de vida a un costo menor que otras intervenciones de salud esenciales.
Área de la Ciencia:
- Salud Pública La salud pública.
- Control y Control de Enfermedades Infecciosas
- Economía de la salud Economía de la salud
Sus antecedentes:
- Se debate la rentabilidad de los programas de control de la tuberculosis pulmonar en los países en desarrollo.
- La tuberculosis positiva por esputo y mancha sigue siendo un desafío significativo para la salud pública en estas regiones.
Objetivo del estudio:
- Evaluar el costo-efectividad de los programas de quimioterapia para la tuberculosis pulmonar con esputo positivo en Malawi, Mozambique y Tanzania.
- Para comparar el costo por año de vida ahorrado para diferentes regímenes de quimioterapia y métodos de administración.
Principales métodos:
- Análisis de la relación costo-efectividad utilizando datos de los programas de quimioterapia en Malawi, Mozambique y Tanzania.
- Cálculo de los costos incrementales por año de vida ahorrado por quimioterapia de curso corto y estándar, tanto con como sin ingreso hospitalario.
- Comparación con otras intervenciones de salud establecidas y rentables.
Principales resultados:
- La quimioterapia de corto curso logró tasas de curación del 86-90%, mientras que la quimioterapia estándar logró 60-66%.
- La quimioterapia ambulatoria de curso corto tuvo el costo más bajo por año de vida salvada ($ 0.9-1.1), seguida por la quimioterapia estándar ambulatoria ($ 0.9-1.3).
- La quimioterapia para la tuberculosis positiva a frotis es más rentable que la inmunización contra el sarampión y la terapia de rehidratación oral.
Conclusiones:
- La quimioterapia para la tuberculosis pulmonar positiva por esputo y mancha es una intervención altamente rentable en los países en desarrollo.
- Las estrategias de tratamiento ambulatorio, especialmente la quimioterapia de corto plazo, ofrecen el mejor valor económico.
- El tratamiento de pacientes VIH-seropositivos con tuberculosis es solo marginalmente menos rentable debido a la reducción de los beneficios de transmisión.
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