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A comparison of the yield and relative cost of active tuberculosis case-finding algorithms in Zimbabwe

Machekera, Shepherd
; 
Wilkinson, Ewan
; 
Hinderaker, Sven G.
; 
Mabhala, Mzwandile A.
; 
Zishiri, Christopher
; 
Ncube, Ronald
; 
Sandy, Charles
; 
Timire, Collins
; 
Takarinda, Kudakwashe
; 
Sengai, Tonderai
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Affiliation
University of Chester
EPub Date
Publication Date
2019-06-21
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Health and Social Care
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Abstract
Setting: 10 districts and 3 cities in Zimbabwe Objective: To compare the yield and relative cost of identifying a case of tuberculosis (TB) if the National TB Programme (NTP) used one of three World Health Organisation (WHO)-recommended algorithms (2c,2d,3b) instead of Zimbabwe’s active case finding (ACF) algorithm Design: Cross-sectional study using data from the Zimbabwe ACF project. Results: 38,574 people were screened from April-December 2017 and 488 (1.3%) were diagnosed with TB. WHO-2d had the least number of people needing a chest X-ray (CXR) at 13,710 (35.5%) and bacteriological confirmation at 2,595 (6.7%). If the NTP had used the WHO recommended algorithms, fewer TB cases would have been diagnosed - 18% (88 cases) with algorithm 2b, 25% (122 cases) algorithm 2d, and only 7% (34 cases) with algorithm 3b. The relative cost-per-case of TB diagnosed for the Zimbabwe algorithm at $565 was over three times that of WHO 3b algorithm ($180) which was the cheapest. Conclusion: The Zimbabwe ACF algorithm had the highest yield but at a considerable cost when compared to WHO algorithms. The trade-off between cost and yield needs to be reviewed by the NTP and changing to use algorithm 3d considered.
Citation
Machekera, S., Wilkinson, E., Hinderaker, S. G., Mabhala, M., Zishiri, C., Ncube, R., Sandy, C., Timire, C., Takarinda, K. & Sengai, T. (2019). A comparison of the yield and relative cost of active tuberculosis case-finding algorithms in Zimbabwe. Public Health Action, 9(2), 63-68.
Publisher
International Union Against Tuberculosis and Lung Disease
Journal
Public Health Action
Research Unit
URI
http://hdl.handle.net/10034/622378
DOI
10.5588/pha.18.0098
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Article
Language
en
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2220-8372
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https://www.theunion.org/what-we-do/journals/pha
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