Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa
Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa
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DOI：
10.2471/blt.04.018606
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发表时间：
2006-07-10
期刊：
影响因子：
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通讯作者：
Godfrey-Faussett, Peter
中科院分区：
文献类型：
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作者：
Hausler, Harry Peter;Sinanovic, Edina;Godfrey-Faussett, Peter
目的测量开普敦初级卫生保健机构结核病/人类免疫缺陷病毒（TB/HIV）干预的ProTEST包的成本并估计其成本效益，方法我们回顾性地收集了年度成本数据，基于三个初级保健设施的成本计算，并估计了避免艾滋病毒感染的成本和预防结核病的成本。三个设施的预防艾滋病毒/艾滋病检测方案干预措施的费用为：自愿咨询和检测7-11美元，检测结核病病例81-166美元，完成异烟肼预防治疗92-183美元，完成6个月的复方新诺明预防治疗20-44美元。通过自愿咨询和检测避免的每例艾滋病毒感染的估计费用为67-112美元。通过自愿咨询和检测（通过预防艾滋病毒）预防的每个结核病例的费用为129-215美元，通过加强病例发现预防的每个结核病例的费用为323-664美元，通过因特网预防和治疗预防的每个结核病例的费用为486-962美元。敏感性分析表明，使用胸部X光进行IPT筛查使IPT预防结核病病例的成本效益降低了36%。IPT筛选或没有结核菌素纯化蛋白衍生物筛选几乎同样具有成本效益。结论我们得出结论，ProTEST包是节省成本。尽管坚持程度不高，但将结核病和艾滋病毒的预防和护理干预措施联系起来，导致预防结核病的估计费用低于先前的治疗费用估计数。
Objective To measure the costs and estimate the cost-effectiveness of the ProTEST package of tuberculosis/human immunodeficiency virus (TB/HIV) interventions in primary health care facilities in Cape Town, South Africa.Methods We collected annual cost data retrospectively using ingredients-based costing in three primary care facilities and estimated the cost per HIV infection averted and the cost per TB case prevented.Findings The range of costs per person for the ProTEST interventions in the three facilities were: US$ 7-11 for voluntary counselling and testing (VCT), US$ 81-166 for detecting a TB case, US$ 92-183 for completing isoniazid preventive therapy (IPT) and US$ 20-44 for completing six months of cotrimoxazole preventive therapy. The estimated cost per HIV infection averted by VCT was US$ 67-112. The cost per TB case prevented by VCT (through preventing HIV) was US$ 129-215, by intensified case finding was US$ 323-664 and by IPT was US$ 486-962. Sensitivity analysis showed that the use of chest X-rays for IPT screening decreases the cost-effectiveness of IPT in preventing TB cases by 36%. IPT screening with or without tuberculin purified protein derivative screening was almost equally cost-effective.Conclusion We conclude that the ProTEST package is cost saving. Despite moderate adherence, linking prevention and care interventions for TB and HIV resulted in the estimated costs of preventing TB being less than previous estimates of costs of treating it. VCT was less expensive than previously reported in Africa.