Cost-effectiveness of chest x-ray screening for diagnosis and treatment of inactive pulmonary tuberculosis in a high-incidence country.

摘要

Treatment of individuals with inactive pulmonary tuberculosis has been shown to prevent cases of tuberculosis and improve quality-of-life at a "reasonable" cost in North America. The economic feasibility of screening and treatment of inactive pulmonary tuberculosis has not been established in South Africa, a country with an increasing tuberculosis epidemic. As such, cost-effectiveness and cost-utility analyses were performed to determine the benefits and costs of a chest x-ray screening and treatment programme for individuals with inactive pulmonary tuberculosis in South Africa. Comparing this intervention with usual care, the incremental cost per QALY gained and the cost per active case of tuberculosis prevented were 31,043 Rand and 17,384 Rand respectively. Screening and treating individuals thirty-five years of age and older instead of individuals fifteen years of age and older and use of miniature chest x-rays for screening instead of conventional chest radiography improved the economic attractiveness of the proposed programme.