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Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru

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dc.contributor.author Shah, L.
dc.contributor.author Rojas, M.
dc.contributor.author Mori, O.
dc.contributor.author Zamudio Fuertes, Carlos Eduardo
dc.contributor.author Kaufman, J. S.
dc.contributor.author Otero Vegas, Larissa
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Seas Ramos, Carlos Rafael
dc.contributor.author Brewer, T. F.
dc.date.accessioned 2019-01-25T15:02:22Z
dc.date.available 2019-01-25T15:02:22Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4627
dc.description.abstract We compared the cost-effectiveness (CE) of an active case-finding (ACF) programme for household contacts of tuberculosis (TB) cases enrolled in first-line treatment to routine passive case-finding (PCF) within an established national TB programme in Peru. Decision analysis was used to model detection of TB in household contacts through: (1) self-report of symptomatic cases for evaluation (PCF), (2) a provider-initiated ACF programme, (3) addition of an Xpert MTB/RIF diagnostic test for a single sputum sample from household contacts, and (4) all strategies combined. CE was calculated as the incremental cost-effectiveness ratio (ICER) in terms of US dollars per disability-adjusted life years (DALYs) averted. Compared to PCF alone, ACF for household contacts resulted in an ICER of $2155 per DALY averted. The addition of the Xpert MTB/RIF diagnostic test resulted in an ICER of $3275 per DALY averted within a PCF programme and $3399 per DALY averted when an ACF programme was included. Provider-initiated ACF of household contacts in an urban setting of Lima, Peru can be highly cost-effective, even including costs to seek out contacts and perform an Xpert/MTB RIF test. ACF including Xpert MTB/RIF was not cost-effective if TB cases detected had high rates of default from treatment or poor outcomes. en_US
dc.language.iso eng
dc.publisher Cambridge University Press
dc.relation.ispartofseries Epidemiology and Infection
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Endemic Diseases en_US
dc.subject Peru/epidemiology en_US
dc.subject Family Characteristics en_US
dc.subject HIV Infections/epidemiology en_US
dc.subject Case-finding en_US
dc.subject community epidemics en_US
dc.subject Cost-Benefit Analysis en_US
dc.subject cost-effectiveness en_US
dc.subject public health en_US
dc.subject tuberculosis (TB) en_US
dc.subject Diagnostic Tests, Routine/economics/methods en_US
dc.subject Mass Screening/economics/methods en_US
dc.subject Tuberculosis, Pulmonary/diagnosis/epidemiology en_US
dc.title Cost-effectiveness of active case-finding of household contacts of pulmonary tuberculosis patients in a low HIV, tuberculosis-endemic urban area of Lima, Peru en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1017/S0950268816003186
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.09
dc.relation.issn 1469-4409


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