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Economic Evaluation of Community Tuberculosis Active Case-Finding Approaches in Cambodia: A Quasi-Experimental Study

Author

Listed:
  • Alvin Kuo Jing Teo

    (Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore)

  • Kiesha Prem

    (Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
    Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK)

  • Yi Wang

    (Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore)

  • Tripti Pande

    (McGill International TB Centre, Montreal, QC H4A 3S5, Canada)

  • Marina Smelyanskaya

    (Stop TB Partnership, 1218 Geneva, Switzerland)

  • Lisanne Gerstel

    (KIT Royal Tropical Institute, 1092 AD Amsterdam, The Netherlands)

  • Monyrath Chry

    (Cambodia Anti-Tuberculosis Association, Phnom Penh 12303, Cambodia)

  • Sovannary Tuot

    (KHANA Centre for Population Health Research, Phnom Penh 12301, Cambodia
    Faculty of Social Sciences and Humanity, Royal University of Phnom Penh, Phnom Penh 12150, Cambodia
    Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan)

  • Siyan Yi

    (Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore 117549, Singapore
    KHANA Centre for Population Health Research, Phnom Penh 12301, Cambodia
    Center for Global Health Research, Touro University California, Vallejo, CA 94592, USA)

Abstract

This study aimed to estimate the costs and incremental cost-effectiveness of two community-based tuberculosis (TB) active case-finding (ACF) strategies in Cambodia. We also assessed the number needed to screen and test to find one TB case. Program and national TB notification data from a quasi-experimental study of a cohort of people with TB in 12 intervention operational districts (ODs) and 12 control ODs between November 2018 and December 2019 were analyzed. Two ACF interventions (ACF seed-and-recruit (ACF SAR) model and one-off roving (one-off) ACF) were implemented concurrently. The matched control sites included PCF only. We estimated costs using the program and published data in Cambodia. The primary outcome was disability-adjusted life years (DALY) averted over 14 months. We considered the gross domestic product per capita of Cambodia in 2018 as the cost-effectiveness threshold. ACF SAR needed to test 7.7 people with presumptive TB to identify one all-forms TB, while one-off ACF needed to test 22.4. The costs to diagnose one all-forms TB were USD 458 (ACF SAR) and USD 191 (one-off ACF). The incremental cost per DALY averted was USD 257 for ACF SAR and USD 204 for one-off ACF. Community-based ACF interventions that targeted key populations for TB in Cambodia were highly cost-effective.

Suggested Citation

  • Alvin Kuo Jing Teo & Kiesha Prem & Yi Wang & Tripti Pande & Marina Smelyanskaya & Lisanne Gerstel & Monyrath Chry & Sovannary Tuot & Siyan Yi, 2021. "Economic Evaluation of Community Tuberculosis Active Case-Finding Approaches in Cambodia: A Quasi-Experimental Study," IJERPH, MDPI, vol. 18(23), pages 1-16, December.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:23:p:12690-:d:693165
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    References listed on IDEAS

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    1. Nicholas Graves & Damian Walker & Rosalind Raine & Andrew Hutchings & Jennifer A. Roberts, 2002. "Cost data for individual patients included in clinical studies: no amount of statistical analysis can compensate for inadequate costing methods," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 735-739, December.
    2. Sarah Wood Pallas & Marissa Courey & Chhaily Hy & Wm. Perry Killam & Dora Warren & Brittany Moore, 2018. "Cost Analysis of Tuberculosis Diagnosis in Cambodia with and without Xpert® MTB/RIF for People Living with HIV/AIDS and People with Presumptive Multidrug-resistant Tuberculosis," Applied Health Economics and Health Policy, Springer, vol. 16(4), pages 537-548, August.
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