Screening strategies for active tuberculosis: focus on cost-effectiveness
Claudia Caroline Dobler Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia Abstract: In recent years, there has been renewed interest in screening for active tuberculosis (TB), also called active case-finding (ACF), as a possible means to...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2016-06-01
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| Series: | ClinicoEconomics and Outcomes Research |
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| Online Access: | https://www.dovepress.com/screening-strategies-for-active-tuberculosis-focus-on-cost-effectivene-peer-reviewed-article-CEOR |
| _version_ | 1811202264339054592 |
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| author | Dobler CC |
| author_facet | Dobler CC |
| author_sort | Dobler CC |
| collection | DOAJ |
| description | Claudia Caroline Dobler Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia Abstract: In recent years, there has been renewed interest in screening for active tuberculosis (TB), also called active case-finding (ACF), as a possible means to achieve control of the global TB epidemic. ACF aims to increase the detection of TB, in order to diagnose and treat patients with TB earlier than if they had been diagnosed and treated only at the time when they sought health care because of symptoms. This will reduce or avoid secondary transmission of TB to other people, with the long-term goal of reducing the incidence of TB. Here, the history of screening for active TB, current screening practices, and the role of TB-diagnostic tools are summarized and the literature on cost-effectiveness of screening for active TB reviewed. Cost-effectiveness analyses indicate that community-wide ACF can be cost-effective in settings with a high incidence of TB. ACF among close TB contacts is cost-effective in settings with a low as well as a high incidence of TB. The evidence for cost-effectiveness of screening among HIV-infected persons is not as strong as for TB contacts, but the reviewed studies suggest that the intervention can be cost-effective depending on the background prevalence of TB and test volume. None of the cost-effectiveness analyses were informed by data from randomized controlled trials. As the results of randomized controlled trials evaluating different ACF strategies will become available in future, we will hopefully gain a better understanding of the role that ACF can play in achieving global TB control. Keywords: disease elimination, epidemic, active case-finding, review |
| first_indexed | 2024-04-12T02:35:59Z |
| format | Article |
| id | doaj.art-f7dbf791fc704cbda9026fe2bbe43bd5 |
| institution | Directory Open Access Journal |
| issn | 1178-6981 |
| language | English |
| last_indexed | 2024-04-12T02:35:59Z |
| publishDate | 2016-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | ClinicoEconomics and Outcomes Research |
| spelling | doaj.art-f7dbf791fc704cbda9026fe2bbe43bd52022-12-22T03:51:33ZengDove Medical PressClinicoEconomics and Outcomes Research1178-69812016-06-012016Issue 133534727701Screening strategies for active tuberculosis: focus on cost-effectivenessDobler CCClaudia Caroline Dobler Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia Abstract: In recent years, there has been renewed interest in screening for active tuberculosis (TB), also called active case-finding (ACF), as a possible means to achieve control of the global TB epidemic. ACF aims to increase the detection of TB, in order to diagnose and treat patients with TB earlier than if they had been diagnosed and treated only at the time when they sought health care because of symptoms. This will reduce or avoid secondary transmission of TB to other people, with the long-term goal of reducing the incidence of TB. Here, the history of screening for active TB, current screening practices, and the role of TB-diagnostic tools are summarized and the literature on cost-effectiveness of screening for active TB reviewed. Cost-effectiveness analyses indicate that community-wide ACF can be cost-effective in settings with a high incidence of TB. ACF among close TB contacts is cost-effective in settings with a low as well as a high incidence of TB. The evidence for cost-effectiveness of screening among HIV-infected persons is not as strong as for TB contacts, but the reviewed studies suggest that the intervention can be cost-effective depending on the background prevalence of TB and test volume. None of the cost-effectiveness analyses were informed by data from randomized controlled trials. As the results of randomized controlled trials evaluating different ACF strategies will become available in future, we will hopefully gain a better understanding of the role that ACF can play in achieving global TB control. Keywords: disease elimination, epidemic, active case-finding, reviewhttps://www.dovepress.com/screening-strategies-for-active-tuberculosis-focus-on-cost-effectivene-peer-reviewed-article-CEORtuberculosisscreeningactive case findingcost-effectivenessreview |
| spellingShingle | Dobler CC Screening strategies for active tuberculosis: focus on cost-effectiveness ClinicoEconomics and Outcomes Research tuberculosis screening active case finding cost-effectiveness review |
| title | Screening strategies for active tuberculosis: focus on cost-effectiveness |
| title_full | Screening strategies for active tuberculosis: focus on cost-effectiveness |
| title_fullStr | Screening strategies for active tuberculosis: focus on cost-effectiveness |
| title_full_unstemmed | Screening strategies for active tuberculosis: focus on cost-effectiveness |
| title_short | Screening strategies for active tuberculosis: focus on cost-effectiveness |
| title_sort | screening strategies for active tuberculosis focus on cost effectiveness |
| topic | tuberculosis screening active case finding cost-effectiveness review |
| url | https://www.dovepress.com/screening-strategies-for-active-tuberculosis-focus-on-cost-effectivene-peer-reviewed-article-CEOR |
| work_keys_str_mv | AT doblercc screeningstrategiesforactivetuberculosisfocusoncosteffectiveness |