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增加结核病家庭接触调查在乌干达西南部被动发现病例策略的成本效益分析

Dickens Odongo¹, Bernard Omech¹, Alfred Acanga²

¹Department of Environmental Health and Disease Control, Faculty of Public Health, Lira University, Lira, Uganda.

|December 21, 2023

概括

将家庭接触调查 (HCI) 添加到乌干达结核病被动病例调查 (PCF) 中是不具有成本效益的. 然而,HCI有效地识别儿童和PLHIV的结核病,而PCF更好地检测男性的结核病.

科学领域:

公共卫生公共卫生
卫生经济学卫生经济学
传染病流行病学传染病流行病学

背景情况:

在发展中国家,结核病 (TB) 的标准被动病例调查 (PCF) 不足.
家庭接触调查 (HCI) 是一种替代方案,但其在低收入和中等收入国家中的成本效益研究不足.
这项研究评估了在乌干达西南部将HCI与PCF集成的成本效益.

研究的目的:

评估将家庭接触调查 (HCI) 添加到现有的被动发现病例 (PCF) 战略,以控制乌干达西南部的结核病的成本效益.
为了比较PCF和HCI策略之间的结核病检测收益率和成本.
在类似的环境中为结核病控制计划的资源分配提供信息.

主要方法:

一个回顾性经济评估,使用自下而上的成本计算技术.
来自地区卫生信息系统 (DHIS 2),结核病登记册和初级成本调查的综合数据.
比较PCF (自我报告或医疗保健工作者提示) 和HCI (家庭访问,接触查) 使用决策分析建模超过1.5年.

主要成果:

每个检测到的结核病例的单位成本:PCF为204.22美元,HCI为315.07美元.
患者和护理人员的费用是PCF (26.37美元) 的五倍高于HCI (5.42美元).
结核病查收益率:PCF的0.52%,HCI的5.8%. 在儿童 (6.2%) 和艾滋病毒感染者 (PLHIV) (15.8%) 中,HCI的产量更高. 在男性中,PCF的产量更高 (1.12%). 选所需的数量 (NNS):PCF为193个,HCI为17个.

结论:

根据该研究的假设,在非洲农村环境中将HCI添加到PCF中并不具有成本效益.
HCI有效地识别了儿童和PLHIV的结核病,应该优先考虑这些群体.
PCF仍然是检测男性结核病的低成本策略.

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