Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review

作者：Hannah Alsdurf, Brianna Empringham, Cecily Miller, Alice Zwerling · 发表于：BMC Infectious Diseases · 年份：2021 · DOI：10.1186/s12879-021-06633-3 · 被引用次数：44 · 研究领域：Tuberculosis Research and Epidemiology、Diagnosis and treatment of tuberculosis、Infectious Diseases and Tuberculosis

BACKGROUND: Systematic screening for active tuberculosis (TB) is a strategy which requires the health system to seek out individuals, rather than waiting for individuals to self-present with symptoms (i.e., passive case finding). Our review aimed to summarize the current economic evidence and understand the costs and cost-effectiveness of systematic screening approaches among high-risk groups and settings. METHODS: We conducted a systematic review on economic evaluations of screening for TB disease targeting persons with clinical and/or structural risk factors, such as persons living with HIV (PLHIV) or persons experiencing homelessness. We searched three databases for studies published between January 1, 2010 and February 1, 2020. Studies were included if they reported cost and a key outcome measure. Owing to considerable heterogeneity in settings and type of screening strategy, we synthesized data descriptively. RESULTS: A total of 27 articles were included in our review; 19/27 (70%) took place in high TB burden countries. Seventeen studies took place among persons with clinical risk factors, including 14 among PLHIV, while 13 studies were among persons with structural risk factors. Nine studies reported incremental cost-effectiveness ratios (ICERs) ranging from US$51 to $1980 per disability-adjusted life year (DALY) averted. Screening was most cost-effective among PLHIV. Among persons with clinical and structural risk factors there was limited evidence, but screening was g...