From: Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review
First author, Year | Country | Screening algorithm | Source of unit costs | Type of unit costs | Average cost1 of screening per person | Average cost1 of diagnosis per person | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Screening | Diagnostic tests | Staff | Equipment | Consumables | Overhead | Transport | TB Treatment | |||||||
Persons with structural risk factors (N = 16)a | ||||||||||||||
Migrants, refugees, internally displaced persons (IDPs) | ||||||||||||||
Bogdanova 2019 | Russia | Mass CXR screening | SSM | Reported | ✓ | ✓ | ✓ | $4 per migrant screened | $834 per TB case diagnosed | |||||
Smit 2017 | Belgium | WHO 4SS, CXR | NR | Calculated | ✓ | ✓ | $18 per migrant screened | $506,025 per migrant diagnosed with TB | ||||||
NR | $6721 per asylum seeker diagnosed with TB | |||||||||||||
Homeless persons and intravenous drug users (IDUs) | ||||||||||||||
Bogdanova 2019 | Russia | Mass CXR screening | SSM | Reported | ✓ | ✓ | ✓ | $4-$13 | $793 per TB case diagnosed | |||||
Jit 2011 | United Kingdom | Mobile CXR screening for IDUs and homeless | NR | Reported | ✓ | ✓ | ✓ | ✓ | ✓ | NR | $9837 per QALY gained (UR: $6,302-$27,666) | |||
Persons who live in urban slums | ||||||||||||||
Sekandi 2015 | Uganda | WHO 4SS for all HHC | SSM and CXR | Reported | ✓ | ✓ | ✓ | ✓ | NR | $1371 per additional TB case diagnosed | ||||
Shah 2017 | Peru | Household visits for WHO 4SS for all HHC | Xpert MTB/RIF | Reported | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | $32 per person screened | $3244 per DALY averted | ||
James 2017 | Cambodia | Door-to-door WHO 4SS | SSM and Xpert | Reported | ✓ | ✓ | ✓ | NR | $268 per TB case diagnosed | |||||
Members of tribal or indigenous populations | ||||||||||||||
Sohn 2019 | India | Household visits for TB education and screening | SSM | Reported | ✓ | ✓ | ✓ | < $1 per person screened | $3–5 per TB case diagnosed | |||||
Persons residing in prisons | ||||||||||||||
Machekera 2019 | Zimbabwe | WHO 4SS, CXR | Xpert MTB/RIF | Calculated | ✓ | ✓ | $14 per person screened | $460 per TB case diagnosed | ||||||
Smit 2017 | Belgium | WHO 4SS, CXR | NR | Calculated | ✓ | ✓ | $18 per person screened | $14,034 per TB case diagnosed | ||||||
Winetsky 2012 | Former Soviet Union | WHO 4SS alone | NR | Reported | ✓ | ✓ | ✓ | ✓ | $3 per person screened | $538 per QALY gained | ||||
MMR (CXR) | NR | Reported | ✓ | ✓ | ✓ | ✓ | $5 per person screened | |||||||
Xpert MTB/RIF | NR | Reported | ✓ | ✓ | ✓ | ✓ | $2 per person screened | |||||||
Zishiri 2014 | South Africa | WHO 4SS | Xpert MTB/RIF | Reported | ✓ | ✓ | ✓ | ✓ | ✓ | $33 per person screened | $1423 TB case diagnosed | |||
Elderly (55 +) | ||||||||||||||
Jo 2020 | Cambodia (> 55) | Symptom screen | Xpert, SSM, CXR | Reported | ✓ | ✓ | ✓ | ✓ | ✓ | < $1 per person screened | $406 per TB case diagnosed | |||
James 2017 | Cambodia (> 55) | Symptom screen | Xpert, CXR | Calculated | ✓ | ✓ | ✓ | ✓ | < $2 per person screened | $340 per TB case diagnosed | ||||
Zhang 2017 | China (> 65) | Door-to-door symptom screen or CXR | CXR, SSM, culture | Reported | ✓ | ✓ | ✓ | ✓ | NR | $74–$315 per TB case diagnosed | ||||
People living in areas with limited access to healthcare (remote, isolated, hard-to-reach areas) | ||||||||||||||
Karki 2017 | Papua New Guinea | Community-wide symptom screening | SSM | Reported | ✓ | ✓ | ✓ | NR | $158 per TB case diagnosed | |||||
Jo 2020 | Cambodia | Symptom screen | Xpert, SSM, CXR | Reported | ✓ | ✓ | ✓ | ✓ | ✓ | < $1 per person screened | $406 per TB case diagnosed | |||
Miners (i.e., workers with silica exposure) | ||||||||||||||
Machekera 2019 | Zimbabwe | WHO 4SS, CXR | Xpert MTB/RIF | Calculated | ✓ | ✓ | $14 per person screened | $404 per miner diagnosed | ||||||
Persons with clinical risk factors (N = 3)b | ||||||||||||||
Diabetes mellitus | ||||||||||||||
Bogdonova 2019 | Russia | CXR | SSM | Reported | ✓ | ✓ | ✓ | NR | $21,780 per TB case diagnosed | |||||
Ji 2020 | China | CXR | SSM | Calculated | ✓ | ✓ | ✓ | ✓ | < $2 per person screened | $288 per DALY averted | ||||
Machekera 2019 | Zimbabwe | CXR | Xpert | Reported | ✓ | ✓ | ✓ | NR | $2191 per TB case diagnosed | |||||
Respiratory disease | ||||||||||||||
Bogdonova 2019 | Russia | CXR | SSM | Reported | ✓ | ✓ | ✓ | NR | $32,746 per TB case diagnosed | |||||
Gastro-intestinal, genito-urinary, steroid use or fibrotic chest lesions | ||||||||||||||
Bogdonova 2019 | Russia | CXR | SSM | Reported | ✓ | ✓ | ✓ | NR | $11,648-$105,754 per TB case diagnosed |