Cost to perform door-to-door universal sputum screening for TB in a high-burden community.
Int J Tuberc Lung Dis
; 27(3): 195-201, 2023 03 01.
Article
em En
| MEDLINE
| ID: mdl-36855034
ABSTRACT
BACKGROUND:
Population-based active case-finding (ACF) identifies people with TB in communities but can be costly.METHODS:
We conducted an empiric costing study within a door-to-door household ACF campaign in an urban community in Uganda, where all adults, regardless of symptoms, were screened by sputum Xpert Ultra testing. We used a combination of direct observation and self-reported logs to estimate staffing requirements. Study budgets were reviewed to collect costs of overheads, equipment, and consumables. Our primary outcome was the cost per person diagnosed with TB.RESULTS:
Over a 28-week period, three teams of two people collected sputum from 11,341 adults, of whom 48 (0.4%) tested positive for TB. Screening 1,000 adults required 258 person-hours of effort at a cost of US$35,000, 70% of which was for GeneXpert cartridges. The estimated cost per person screened was $36 (95% uncertainty range [95% UR] 3438), and the cost per person diagnosed with Xpert-positive TB was $8,400 (95% UR 8,0008,900). The prevalence of TB in the underlying community was the primary modifiable determinant of the cost per person diagnosed.CONCLUSION:
Door-to-door screening can be feasibly performed at scale, but will require effective triage and identification of high-prevalence populations to be affordable and cost-effective.
Texto completo:
1
Temas:
ECOS
/
Aspectos_gerais
/
Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Escarro
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Tuberculose
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Programas de Rastreamento
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Triagem
Tipo de estudo:
Diagnostic_studies
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Health_economic_evaluation
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Humans
País/Região como assunto:
Africa
Idioma:
En
Revista:
Int J Tuberc Lung Dis
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos