The effectiveness, cost-effectiveness, budget impact, and return on investment of scaling up tuberculosis screening and preventive treatment in Brazil, Georgia, Kenya, and South Africa: a modelling study

作者：Juan F Vesga, Mona Salaheldin Mohamed, Monica Shandal, Elias Jabbour, Nino Lomtadze, Mmamapudi Kubjane, Anete Trajman, Gesine Meyer‐Rath, Zaza Avaliani, Wesley Rotich, Daniel Mwai, Júlio Croda, Hlengani Mathema, Immaculate Kathure, Rhoda Pola, Fernanda Dockhorn Costa, Norbert Ndjeka, Maka Danelia, Maiko Luís Tonini, Nelly Solomonia, Daniele Maria Pelissari, Dennis Falzon, Cecily Miller, Inés García Baena, Nimalan Arinaminpathy, Kevin Schwartzman, Saskia den Boon, Jonathon R. Campbell · 发表于：The Lancet Global Health · 年份：2025 · DOI：10.1016/s2214-109x(25)00321-3 · 被引用次数：7 · 研究领域：Tuberculosis Research and Epidemiology、Healthcare Facilities Design and Sustainability、HIV/AIDS Impact and Responses

BACKGROUND: Closing the tuberculosis diagnostic gap and scaling up tuberculosis preventive treatment (TPT) are two global priorities to end tuberculosis. We aimed to estimate the cost-effectiveness, budget impact, and societal return on investment of a comprehensive intervention to improve tuberculosis screening and prevention in Brazil, Georgia, Kenya, and South Africa-four distinct epidemiological settings. METHODS: In this modelling study, in partnership with national tuberculosis programmes we defined a set of interventions (the intervention package) related to tuberculosis screening and TPT in three priority populations: people with HIV, household contacts, and a country-defined high-risk population (people deprived of liberty [Brazil], people accessing care for injection drug use [Georgia], people in informal settlements in nine districts with a high prevalence of tuberculosis [Kenya], and people in the 22 subdistricts with the highest prevalence of tuberculosis [South Africa]). We developed transmission models calibrated to country-specific epidemiology and collated cost data for tuberculosis-related activities and patient costs in 2023 US dollars (US$). We compared the intervention package scaled up to reach all priority populations by 2030 to a status quo scenario based on projected tuberculosis epidemiology over a 27-year time horizon (Jan 1, 2024, to Dec 31, 2050); to delineate the impact of intervention components, we also evaluated the intervention package withou...