File Download
There are no files associated with this item.
Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1164/rccm.201004-0620OC
- Scopus: eid_2-s2.0-79954619598
- PMID: 21148723
- WOS: WOS:000289955600025
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Costs and consequences of additional chest x-ray in a tuberculosis prevention program in Botswana
Title | Costs and consequences of additional chest x-ray in a tuberculosis prevention program in Botswana |
---|---|
Authors | |
Keywords | Chest x-ray Cost-effectiveness Human immunodeficiency virus Isoniazid preventive therapy Tuberculosis |
Issue Date | 2011 |
Citation | American Journal of Respiratory and Critical Care Medicine, 2011, v. 183, n. 8, p. 1103-1111 How to Cite? |
Abstract | Rationale: Isoniazid preventive therapy is effective in reducing the risk of tuberculosis (TB)inpersons living with HIV(PLWH);however, screening must exclude TB disease before initiating therapy. Symptom screening alone may be insufficient to exclude TB disease in PLWH because some PLWH with TB disease have no symptoms. The addition of chestradiography (CXR)may improve disease detection. Objectives: The objective of the present analysis was to compare the costs and effects of the addition of CXR to the symptom screening process against the costs and effects of symptom screening alone. Methods: Using data from Botswana, a decision analytic model was usedtocomparea " Symptomonly" policyagainsta "Symptom1CXR" policy. The outcomes of interest were cost, death, and isoniazid-and multidrug-resistant TB in a hypothetical cohort of 10,000 PLWH. Measurements and Main Results: The Symptom+CXR policy prevented 16 isoniazid-and 0.3 multidrug-resistant TB cases; however, because of attrition from the screening process, there were 98 excess cases of TB, 15 excess deaths, and an additional cost of U.S. $127,100. The Symptom+CXR policy reduced deaths only if attrition was close to zero; however, to eliminate attrition the cost would be U.S. $2.8 million per death averted. These findings did not changein best-and worst-case scenario analyses. Conclusions: In Botswana, a policy with symptom screening only preceding isoniazid-preventive therapy initiation prevents more TB and TB-related deaths, and uses fewer resources, than a policy that uses both CXR and symptom screening.. |
Persistent Identifier | http://hdl.handle.net/10722/326860 |
ISSN | 2023 Impact Factor: 19.3 2023 SCImago Journal Rankings: 5.336 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Samandari, Taraz | - |
dc.contributor.author | Bishai, David | - |
dc.contributor.author | Luteijn, Michiel | - |
dc.contributor.author | Mosimaneotsile, Barudi | - |
dc.contributor.author | Motsamai, Oaitse | - |
dc.contributor.author | Postma, Maarten | - |
dc.contributor.author | Hubben, Gijs | - |
dc.date.accessioned | 2023-03-31T05:27:03Z | - |
dc.date.available | 2023-03-31T05:27:03Z | - |
dc.date.issued | 2011 | - |
dc.identifier.citation | American Journal of Respiratory and Critical Care Medicine, 2011, v. 183, n. 8, p. 1103-1111 | - |
dc.identifier.issn | 1073-449X | - |
dc.identifier.uri | http://hdl.handle.net/10722/326860 | - |
dc.description.abstract | Rationale: Isoniazid preventive therapy is effective in reducing the risk of tuberculosis (TB)inpersons living with HIV(PLWH);however, screening must exclude TB disease before initiating therapy. Symptom screening alone may be insufficient to exclude TB disease in PLWH because some PLWH with TB disease have no symptoms. The addition of chestradiography (CXR)may improve disease detection. Objectives: The objective of the present analysis was to compare the costs and effects of the addition of CXR to the symptom screening process against the costs and effects of symptom screening alone. Methods: Using data from Botswana, a decision analytic model was usedtocomparea " Symptomonly" policyagainsta "Symptom1CXR" policy. The outcomes of interest were cost, death, and isoniazid-and multidrug-resistant TB in a hypothetical cohort of 10,000 PLWH. Measurements and Main Results: The Symptom+CXR policy prevented 16 isoniazid-and 0.3 multidrug-resistant TB cases; however, because of attrition from the screening process, there were 98 excess cases of TB, 15 excess deaths, and an additional cost of U.S. $127,100. The Symptom+CXR policy reduced deaths only if attrition was close to zero; however, to eliminate attrition the cost would be U.S. $2.8 million per death averted. These findings did not changein best-and worst-case scenario analyses. Conclusions: In Botswana, a policy with symptom screening only preceding isoniazid-preventive therapy initiation prevents more TB and TB-related deaths, and uses fewer resources, than a policy that uses both CXR and symptom screening.. | - |
dc.language | eng | - |
dc.relation.ispartof | American Journal of Respiratory and Critical Care Medicine | - |
dc.subject | Chest x-ray | - |
dc.subject | Cost-effectiveness | - |
dc.subject | Human immunodeficiency virus | - |
dc.subject | Isoniazid preventive therapy | - |
dc.subject | Tuberculosis | - |
dc.title | Costs and consequences of additional chest x-ray in a tuberculosis prevention program in Botswana | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1164/rccm.201004-0620OC | - |
dc.identifier.pmid | 21148723 | - |
dc.identifier.scopus | eid_2-s2.0-79954619598 | - |
dc.identifier.volume | 183 | - |
dc.identifier.issue | 8 | - |
dc.identifier.spage | 1103 | - |
dc.identifier.epage | 1111 | - |
dc.identifier.eissn | 1535-4970 | - |
dc.identifier.isi | WOS:000289955600025 | - |