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Cost to perform door-to-door universal sputum screening for TB in a high-burden community

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Baik, Y.; Nakasolya, O.; Isooba, D.; Mukiibi, J.; Kitonsa, P.J.; Erisa, K.C.; Nalutaaya, A.; Robsky, K.O.; Ferguson, O.; Kendall, E.A.; Sohn, H.; Katamba, A.; Dowdy, D.W.

Issue Date
International Union Against Tuberculosis And Lung Disease/Union Internationale Contre la Tuberculose et les Maladies Respiratories
International Journal of Tuberculosis and Lung Disease, Vol.27 No.3, pp.195-201
BACKGROUND: Population-based active case-finding (ACF) identifies people with TB in communities but can be costly.METHODS: We conducted an empiric costing study within a door-to-door household ACF campaign in an urban community in Uganda, where all adults, regardless of symptoms, were screened by sputum Xpert Ultra testing. We used a combination of direct observation and self-reported logs to estimate staffing requirements. Study budgets were reviewed to collect costs of overheads, equipment, and consumables. Our primary outcome was the cost per person diagnosed with TB.RESULTS: Over a 28-week period, three teams of two people collected sputum from 11,341 adults, of whom 48 (0.4%) tested positive for TB. Screening 1,000 adults required 258 person-hours of effort at a cost of US$402,000, 70% of which was for GeneXpert cartridges. The estimated cost per person screened was $36 (95% uncertainty range [95% UR] 34-38), and the cost per person diagnosed with Xpert-positive TB was $8,400 (95% UR 8,000-8,900). The prevalence of TB in the underlying community was the primary modifiable determinant of the cost per person diagnosed.CONCLUSION: Door-to-door screening can be feasibly performed at scale, but will require effective triage and identification of high-prevalence populations to be affordable and cost-effective.
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  • College of Medicine
  • Department of Human Systems Medicine
Research Area 결핵, 국제보건, 에이즈


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