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Cost-effectiveness of tuberculosis screening and isoniazid treatment in the TB/HIV in Rio (THRio) Study.
Azadi, M; Bishai, D M; Dowdy, D W; Moulton, L H; Cavalcante, S; Saraceni, V; Pacheco, A G; Cohn, S; Chaisson, R E; Durovni, B; Golub, J E.
Afiliação
  • Azadi M; Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
  • Bishai DM; Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
  • Dowdy DW; Department of Epidemiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
  • Moulton LH; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
  • Cavalcante S; Municipal Health Secretariat, Rio de Janeiro, Brazil.
  • Saraceni V; Municipal Health Secretariat, Rio de Janeiro, Brazil.
  • Pacheco AG; Scientific Computation Program, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
  • Cohn S; Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Chaisson RE; Department of Epidemiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
  • Durovni B; Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
  • Golub JE; Department of Epidemiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Int J Tuberc Lung Dis ; 18(12): 1443-8, 2014 Dec.
Article em En | MEDLINE | ID: mdl-25517809
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. 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 cost-effective relative to the Brazilian GDP per capita.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Programas de Rastreamento / Custos de Medicamentos / Tuberculose Latente / Coinfecção / Isoniazida / Antituberculosos Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Aspecto: Patient_preference Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Tuberc Lung Dis Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: França
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Programas de Rastreamento / Custos de Medicamentos / Tuberculose Latente / Coinfecção / Isoniazida / Antituberculosos Tipo de estudo: Clinical_trials / Diagnostic_studies / Evaluation_studies / Health_economic_evaluation / Prognostic_studies / Screening_studies Aspecto: Patient_preference Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Int J Tuberc Lung Dis Ano de publicação: 2014 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: França