1921
Volume 90, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

In many high-risk populations, access to tuberculosis (TB) diagnosis and treatment is limited and pockets of high prevalence persist. We estimated the cost-effectiveness of an extensive active case finding program in areas of Cambodia where TB notifications and household poverty rates are highest and access to care is restricted. Thirty operational health districts with high TB incidence and household poverty were randomized into intervention and control groups. In intervention operational health districts, all household and symptomatic neighborhood contacts of registered TB patients of the past two years were encouraged to attend screening at mobile centers. In control districts, routine passive case finding activities continued. The program screened more than 35,000 household and neighborhood contacts and identified 810 bacteriologically confirmed cases. The cost-effectiveness analysis estimated that in these cases the reduction in mortality from 14% to 2% would result in a cost per daily adjusted life year averted of $330, suggesting that active case finding was highly cost-effective.

[open-access] This is an Open Access article distributed under the terms of the American Society of Tropical Medicine and Hygiene's Re-use License which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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2014-05-07
2017-09-22
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References

  1. World Health Organization, 2012. Global Tubercuolsis Report 2012. Geneva: World Health Organization.
  2. Eang MT, Satha P, Yadav RP, Morishita F, Nishikiori N, van-Maaren P, Weezenbeek CL, , 2012. Early detection of tuberculosis through community-based active case finding in Cambodia. BMC Public Health 12: 469.[Crossref]
  3. Lonnroth K, Corbett E, Golub J, Godfrey-Faussett P, Uplekar M, Weil D, Raviglione M, , 2013. Systematic screening for active tuberculosis: rationale, definitions and key considerations. Int J Tuberc Lung Dis 17: 289298.[Crossref]
  4. National Institute of Statistics, 2008. General Population Census of Cambodia 2008. Phnom Penh, Cambodia: National Institute of Statistics.
  5. National Center for Tuberculosis and Leprosy Control, 2010. Annual Report for 2009. Phnom Penh, Cambodia: CENAT.
  6. World Health Organization, 2003. WHO Guide to Cost-effectiveness Analysis. Geneva: World Health Organization.
  7. Pichenda K, Nakamura K, Morita A, Kizuki M, Seino K, Takano T, , 2012. Non-hospital DOT and early diagnosis of tuberculosis reduce costs while achieving treatment success. Int J Tuberc Lung Dis 16: 828834.
  8. Frieden T, , 2004. Toman's Tuberculosis Case Detection, Treatment and Monitoring: Questions and Answers. Geneva: World Health Organization.
  9. Tiemersma EW, van der Werf MJ, Borgdorff MW, Williams BG, Nagelkerke NJ, , 2011. Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review. PLoS ONE 6: e17601.[Crossref]
  10. National Tuberculosis Control Program, 2012. Second National Tuberculosis Prevalence Survey Cambodia, 2011. Phnom Penh, Cambodia: CENAT.
  11. Boehme CC, Nicol MP, Nabeta P, Michael JS, Gotuzzo E, Tahirli R, Gler MT, Blakemore R, Worodria W, Gray C, Huang L, Caceres T, Mehdiyev R, Raymond L, Whitelaw A, Sagadevan K, Alexander H, Albert H, Cobelens F, Cox H, Alland D, Perkins MD, , 2011. Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study. Lancet 377: 14951505.[Crossref]
  12. Steingart K, Sohn H, Schiller I, Kloda LA, Boehme CC, Pai M, Dendukuri N, , 2012. Xpert® MTB/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults. Cochrane Database Syst Rev CD009593.
  13. Straetemans M, Glaziou P, Bierrenbach AL, Sismanidis C, van der Werf MJ, , 2011. Assessing tuberculosis case fatality ratio: a meta-analysis. PLoS ONE 6: e20755.[Crossref]
  14. Vassall A, van Kampen S, Sohn H, Michael JS, John KR, den Boon S, Davis JL, Whitelaw A, Nicol MP, Gler MT, Khaliqov A, Zamudio C, Perkins MD, Boehme CC, Cobelens F, , 2011. Rapid diagnosis of tuberculosis with the Xpert MTB/RIF assay in high burden countries: a cost-effectiveness analysis. PLoS Med 8: e1001120.[Crossref]
  15. Borgdorff MW, Floyd K, Broekmans JF, , 2002. Interventions to reduce tuberculosis mortality and transmission in low- and middle-income countries. Bull World Health Organ 80: 217227.
  16. Mello FC, Bastos LG, Soares SL, Rezende VM, Conde MB, Chaisson RE, Kritski AL, Ruffino-Netto A, Werneck GL, , 2006. Predicting smear negative pulmonary tuberculosis with classification trees and logistic regression: a cross-sectional study. BMC Public Health 6: 43.[Crossref]
  17. Vadwai V, Boehme C, Nabeta P, Shetty A, Alland D, Rodrigues C, , 2011. Xpert MTB/RIF: a new pillar in diagnosis of extrapulmonary tuberculosis? J Clin Microbiol 49: 25402545.[Crossref]
  18. van't Hoog AH, Meme HK, Laserson KF, Agaya JA, Muchiri BG, Githui WA, Odeny LO, Marston BJ, Borgdorff MW, , 2012. Screening strategies for tuberculosis prevalence surveys: the value of chest radiography and symptoms. PLoS ONE 7: e38691.[Crossref]
  19. Nishikiori N, Van Weezenbeek C, , 2013. Target prioritization and strategy selection for active case-finding of pulmonary tuberculosis: a tool to support country-level project planning. BMC Public Health 13: 97.[Crossref]
  20. Fox GJ, Dobler CC, Marks GB, , 2011. Active case finding in contacts of people with tuberculosis. Cochrane Database Syst Rev CD008477.
  21. Kranzer K, Lawn SD, Meyer-Rath G, Vassall A, Raditlhalo E, Govindasamy D, van Schaik N, Wood R, Bekker LG, , 2012. Feasibility, yield, and cost of active tuberculosis case finding linked to a mobile HIV service in Cape Town, South Africa: a cross-sectional study. PLoS Med 9: e1001281.[Crossref]
  22. Mupere E, Schiltz NK, Mulogo E, Katamba A, Nabbuye-Sekandi J, Singer ME, , 2013. Effectiveness of active case-finding strategies in tuberculosis control in Kampala, Uganda. Int J Tuberc Lung Dis 17: 207213.[Crossref]
  23. Baltussen R, Floyd K, Dye C, , 2005. Cost effectiveness analysis of strategies for tuberculosis control in developing countries. BMJ 331: 1364.[Crossref]
  24. Dowdy DW, , 2012. Economic analyses of diagnostics for tuberculosis: what's the point? Expert Rev Pharmacoecon Outcomes Res 12: 137139.[Crossref]
  25. Dowdy DW, O'Brien MA, Bishai D, , 2008. Cost-effectiveness of novel diagnostic tools for the diagnosis of tuberculosis. Int J Tuberc Lung Dis 12: 10211029.
  26. Salomon JA, Vos T, Hogan DR, Gagnon M, Naghavi M, Mokdad A, Begum N, Shah R, Karyana M, Kosen S, Farje MR, Moncada G, Dutta A, Sazawal S, Dyer A, Seiler J, Aboyans V, Baker L, Baxter A, Benjamin EJ, Bhalla K, Bin Abdulhak A, Blyth A, Bourne R, Braithwaite T, Brooks P, Brugha TS, Bryan-Hancock C, Buchbinder R, Burney P, Calabria B, Chen H, Chugh SS, Cooley R, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, Davis A, Degenhardt L, Díaz-Torné C, Dorsey ER, Driscoll T, Edmond K, Elbaz A, Ezzati M, Feigin V, Ferri CP, Flaxman AD, Flood L, Fransen M, Fuse K, Gabbe BJ, Gillum RF, Haagsma J, Harrison JE, Havmoeller R, Hay RJ, Hel-Baqui A, Hoek HW, Hoffman H, Hogeland E, Hoy D, Jarvis D, Karthikeyan G, Knowlton LM, Lathlean T, Leasher JL, Lim SS, Lipschultz SE, Lopez AD, Lozano R, Lyons R, Malekzadeh R, Marcenes W, March L, Margolis DL, McGill N, McGrath J, Mensah GA, Meyer AC, Michaud C, Moran A, Mori R, Murdoch ME, Naldi L, Newton CR, Norman R, Omer SB, Osborne R, Pearce N, Perez-Ruiz F, Perico N, Pesudovs K, Phillips D, Pourmalek F, Rehm JT, Prince M, Remuzzi G, Richardson K, Room R, Saha S, Sampson U, Sanchez-Riera L, Segui-Gomez M, Shahraz S, Shibuya K, Singh D, Sliwa K, Smith E, Soeriomataram I, Steiner T, Stolk WA, Stovner LJ, Sudfeld C, Taylor HR, Tleyjeh IM, van der Werf MJ, Watson WL, Weatherall DJ, Weintraub R, Weisskopf MG, Whiteford H, Wilkinson JD, Woolf AD, Zheng ZJ, Murray CJ, Jonas JB, , 2012. Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010. Lancet 380: 21292143.[Crossref]
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  • Received : 22 Jul 2013
  • Accepted : 17 Dec 2013

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