越南全民肺结核查干预措施的潜在影响,成本和益处:一项数学建模研究
Alvaro Schwalb1,2,3, Katherine C Horton1,2, Jon C Emery1,2
1TB Modelling Group, TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLOS global public health
|September 10, 2025
概括
在越南实施全民结核病 (TB) 查可以加速结核病的减少. 具有成本效益的策略,特别是更便宜的NAAT测试,显示出显著的长期节省和健康益处.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 卫生经济学 卫生经济学
背景情况:
- 全人口查可以减少结核病 (TB) 发病率,但最佳策略需要平衡资源分配.
- 越南的结核病流行病学需要建模,以确定有效的查方法.
研究的目的:
- 模拟和比较越南不同全民结核病查算法的有效性和成本效益.
- 确定达到目标结核病患病率所需的查轮次数.
- 评估NAAT弹成本降低对选结果的影响.
主要方法:
- 一个确定性传播模型被校准为越南的结核病流行病学.
- 模拟了三种选算法:仅NAAT,CXR跟随NAAT,以及CXR.
- 使用ICER评估了成本效益,并预计到2050年节省成本.
主要成果:
- 基于NAAT的算法需要至少六轮;CXR只需要三轮才能达到患病率目标.
- 该CXR+NAAT算法避免了429万次DALY,每次DALY的ICER为225美元.
- 降低NAAT成本显著降低了NAAT单独算法和CXR+NAAT算法的预算影响和ICER.
结论:
- 越南的全民查可以实现雄心勃勃的结核病控制目标.
- 对选的前期投资可以长期节省成本.
- 价格实惠的NAAT弹可以进一步提高结核病查计划的成本效益.
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