scholarly journals Economic Evaluation of Community Tuberculosis Active Case-Finding Approaches in Cambodia: A Quasi-Experimental Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12690
Author(s):  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Yi Wang ◽  
Tripti Pande ◽  
Marina Smelyanskaya ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Case Finding ◽  
Active Case Finding ◽  
Community Based ◽  
Active Case ◽  
Number Needed To Screen ◽  
Life Years ◽  
Quasi Experimental

This study aimed to estimate the costs and incremental cost-effectiveness of two community-based tuberculosis (TB) active case-finding (ACF) strategies in Cambodia. We also assessed the number needed to screen and test to find one TB case. Program and national TB notification data from a quasi-experimental study of a cohort of people with TB in 12 intervention operational districts (ODs) and 12 control ODs between November 2018 and December 2019 were analyzed. Two ACF interventions (ACF seed-and-recruit (ACF SAR) model and one-off roving (one-off) ACF) were implemented concurrently. The matched control sites included PCF only. We estimated costs using the program and published data in Cambodia. The primary outcome was disability-adjusted life years (DALY) averted over 14 months. We considered the gross domestic product per capita of Cambodia in 2018 as the cost-effectiveness threshold. ACF SAR needed to test 7.7 people with presumptive TB to identify one all-forms TB, while one-off ACF needed to test 22.4. The costs to diagnose one all-forms TB were USD 458 (ACF SAR) and USD 191 (one-off ACF). The incremental cost per DALY averted was USD 257 for ACF SAR and USD 204 for one-off ACF. Community-based ACF interventions that targeted key populations for TB in Cambodia were highly cost-effective.

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

2017 ◽  
Vol 145 (6) ◽  
pp. 1107-1117 ◽  
Author(s):  
L. SHAH ◽  
M. ROJAS ◽  
O. MORI ◽  
C. ZAMUDIO ◽  
J. S. KAUFMAN ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Diagnostic Test ◽  
Cost Effective ◽  
Case Finding ◽  
Self Report ◽  
Urban Setting ◽  
Active Case Finding ◽  
Active Case ◽  
Household Contacts ◽  
Life Years

SUMMARYWe 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.

scholarly journals Mobile community-based active case-finding for tuberculosis among older populations in rural Cambodia

2019 ◽  
Vol 23 (10) ◽  
pp. 1107-1114 ◽  
Author(s):  
O. Camelique ◽  
S. Scholtissen ◽  
J.-P. Dousset ◽  
M. Bonnet ◽  
M. Bastard ◽  
...  
Keyword(s):  
Risk Group ◽  
Treatment Success ◽  
Case Finding ◽  
High Risk Group ◽  
Active Case Finding ◽  
Community Based ◽  
Active Case ◽  
Tb Treatment ◽  
Mobile Community ◽  
Older Populations

OBJECTIVE: To systematically screen older rural populations in Cambodia for tuberculosis (TB) and develop an effective active case-finding (ACF) model for this TB high-risk group.DESIGN: A retrospective study using routinely collected programmatic data on community-based ACF among people aged ≥55 years using TB symptoms and systematic chest radiography (CXR) screening, followed by Xpert® MTB/RIF testing for participants with positive screening results and TB culture for certain Xpert-negative specimens.RESULTS: Of 22 101 participants included in the analysis, 7469 (33.8%) were screening-positive and 5960 (27.0%) underwent Xpert testing. Pulmonary TB was identified in 482 (2.2%) individuals: 288 (1.3%) were bacteriologically confirmed (253 using Xpert, 35 using culture) and 194 (0.9%) were clinically diagnosed. Eighty-seven people needed to be screened in order to diagnose one Xpert-positive case. Among the Xpert-positive cases, only 31.6% (80/253) reported cough ≥2 weeks, and 39.9% (101/253) were asymptomatic but had a CXR suggestive of active TB. Treatment uptake was 97.3% (469/482), and treatment success was 88.0% (424/482).CONCLUSIONS: Community-based ACF was effective in detecting and successfully treating older TB patients, most of whom might otherwise have remained undiagnosed. Mobile CXR appears to be crucial in identifying a high number of asymptomatic, bacteriologically confirmed cases.

scholarly journals Correction to: Role of community-based active case finding in screening tuberculosis in Yunnan province of China

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Jin-Ou Chen ◽  
Yu-Bing Qiu ◽  
Zulma Vanessa Rueda ◽  
Jing-Long Hou ◽  
Kun-Yun Lu ◽  
...  
Keyword(s):  
Yunnan Province ◽  
Case Finding ◽  
Active Case Finding ◽  
Community Based ◽  
Active Case

scholarly journals Cost-Effectiveness of a Tuberculosis Active Case Finding Program Targeting Household and Neighborhood Contacts in Cambodia

2014 ◽  
Vol 90 (5) ◽  
pp. 866-872 ◽  
Author(s):  
Rajendra P. Yadav ◽  
Nobuyuki Nishikiori ◽  
Peou Satha ◽  
Mao T. Eang ◽  
Yoel Lubell
Keyword(s):  
Cost Effectiveness ◽  
Case Finding ◽  
Active Case Finding ◽  
Active Case

scholarly journals Active detection of tuberculosis: tackling the problem head on in the remote area of Andaman and Nicobar Islands

2019 ◽  
Vol 6 (8) ◽  
pp. 3314
Author(s):  
Samarendra Prasanna Burma ◽  
Gunda Jahnavi ◽  
Pappachen Lal ◽  
Pandurang V. Thatkar
Keyword(s):  
Case Finding ◽  
Nucleic Acid Amplification ◽  
Sputum Smear ◽  
Active Case Finding ◽  
Community Based ◽  
Cross Sectional ◽  
X Ray ◽  
Active Case ◽  
Sputum Microscopy ◽  
Team Activity

Background: Community based active case finding for tuberculosis (TB) is an essential step in the fight forward for eliminating TB. One of the steps in targeting TB intervention is early diagnosis and treatment of patients by reducing the reservoir of infection in the community. Active case finding (ACF) targeting the entire population by house to house survey was done in Nicobar district of these islands.Methods: A community-based, cross-sectional, descriptive study was conducted with the trained mobile teams from 17.07.2017 to 31.07.2017 in the Nicobar District. The algorithm of the case detection included screening patients by symptoms, then by sputum microscopy for confirmation. X-ray was done in patients who were symptomatic but sputum negative. If both smear and chest X-ray results were negative but still symptomatic, then cartridge-based nucleic acid amplification test (CBNAAT) was done.Results: A total population of 18526 was mapped of which 14784 (79.8) could be screened. A total of 209 people were identified by the mobile teams with symptoms who were examined by sputum microscopy. Among them 7 cases were identified to be sputum smear positive, 2 X-ray positive and 2 were diagnosed by CBNAAT.Conclusions: This study shows that the active case finding method is feasible and acceptable by the community. The results obtained are encouraging for the implementation of ACF through mobile team activity in all these islands in order to meet the target of WHO’s End TB Strategy.

scholarly journals Is it feasible to carry out active case finding for tuberculosis in community-based settings?

Lung India ◽  
2019 ◽  
Vol 36 (1) ◽  
pp. 28 ◽  
Author(s):  
Kalaiselvi Selvaraj ◽  
Mercy Mani ◽  
Muskura Riyaz ◽  
M Shaheena ◽  
Saravanan Vaithiyalingam ◽  
...  
Keyword(s):  
Case Finding ◽  
Active Case Finding ◽  
Community Based ◽  
Active Case

scholarly journals Active Case Finding for Tuberculosis through TOUCH Agents in Selected High TB Burden Wards of Kolkata, India: A Mixed-methods Study on Outcomes and Implementation Challenges

2019 ◽  
Author(s):  
Abhijit Dey ◽  
Pruthu Thekkur ◽  
Ayan Ghosh ◽  
Tanusree Dasgupta ◽  
Soumyajyoti Bandopadhyay ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Case Finding ◽  
Health Facilities ◽  
Mixed Methods Study ◽  
Attrition Rate ◽  
Active Case Finding ◽  
Identification Rate ◽  
Active Case ◽  
Number Needed To Screen ◽  
Wage Loss

Background: Active case finding for TB was implemented in selected sixty high TB burden wards of Kolkata, India. Community volunteers called TOUCH agents (TAs) identified and referred presumptive TB patients (PTBPs) to health facilities for TB diagnosis and treatment. We aimed to describe the ‘care cascade’ of PTBPs identified during July to December, 2018 and to explore the reasons for attrition as perceived by TAs and PTBPs. Methods: An explanatory mixed methods study with quantitative phase of cohort study using routinely collected data followed by descriptive qualitative study with in-depth interviews was conducted. Results: Of the 3, 86,242 individuals enumerated, 1132 (0.3%) PTBPs were identified. Only 713 (63.0%) PTBPs visited referred facility for TB diagnosis. TB was diagnosed in 177 (24.8%) and the number needed to screen for one TB was 2,183 individuals. The potential reasons for low yield were stigma and apprehension about TB, distrust about TA, wage loss for attending health facilities and substance abuse among PTBPs. Conclusion: The yield of ACF was suboptimal with low PTBP identification rate and high attrition rate. Interviewing each individual for symptoms of TB and supporting PTBPs for diagnosis through sputum collection and transport can be adopted to improve the yield.

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