DESIGN : We used decision analysis, populated by data from a cluster-randomized trial, to project the costs (in 2010 USD) and effectiveness (in disability-adjusted life years [DALYs] averted) of training health care workers to implement the tuberculin skin test (TST), followed by IPT for TST-positive patients with no evidence of active TB. This intervention was compared to a baseline of usual care. We used time horizons of 1 year for the intervention and 20 years for disease outcomes, with all future DALYs and medical costs discounted at 3% per year.
RESULTS : Providing this intervention to 100 people would avert 1.14 discounted DALYs (1.57 undiscounted DALYs). The median estimated incremental cost-effectiveness ratio was $2273 (IQR $1779-$3135) per DALY averted, less than Brazil's 2010 per capita gross domestic product (GDP) of $11 700. Results were most sensitive to the cost of providing the training.
CONCLUSION: Training health care workers to screen HIV-infected adults with TST and provide IPT to those with latent tuberculous infection can be considered costeffective relative to the Brazilian GDP per capita.
OBJECTIVE : To estimate the incremental cost-effectiveness of tuberculosis (TB) screening and isoniazid preventive therapy (IPT) among human immunodeficiency virus (HIV) infected adults in Rio de Janeiro, Brazil.
|Original language||English (US)|
|Number of pages||6|
|Journal||International Journal of Tuberculosis and Lung Disease|
|State||Published - Dec 1 2014|
- Economic analysis
- Skin tests
- TB-HIV co-infection
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Infectious Diseases