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Personal and Societal Health Quality Lost to Tuberculosis

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  • Thaddeus L Miller
  • Scott J N McNabb
  • Peter Hilsenrath
  • Jotam Pasipanodya
  • Stephen E Weis

Abstract

Background: In developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in a majority of patients who have completed treatment for pulmonary tuberculosis (PTB). This and other health effects of tuberculosis have not been considered in QALY calculations. Consequently both the burden of tuberculosis on the individual and the value of tuberculosis prevention to society are underestimated. We estimated QALYs lost to pulmonary TB patients from all known sources, and estimated health loss to prevalent TB disease. Methodology/Principal Findings: We calculated values for health during illness and treatment, pulmonary impairment after tuberculosis (PIAT), death rates, years-of-life-lost to death, and normal population health. We then compared the lifetime expected QALYs for a cohort of tuberculosis patients with that expected for comparison populations with latent tuberculosis infection and without tuberculosis infection. Persons with culture-confirmed tuberculosis accrued fewer lifetime QALYs than those without tuberculosis. Acute tuberculosis morbidity cost 0.046 QALYs (4% of total) per individual. Chronic morbidity accounted for an average of 0.96 QALYs (78% of total). Mortality accounted for 0.22 QALYs lost (18% of total). The net benefit to society of averting one case of PTB was about 1.4 QALYs. Conclusions/Significance: Tuberculosis, a preventable disease, results in QALYs lost owing to illness, impairment, and death. The majority of QALYs lost from tuberculosis resulted from impairment after microbiologic cure. Successful TB prevention efforts yield more health quality than previously thought and should be given high priority by health policy makers. (Refer to Abstracto S1 for Spanish language abstract)

Suggested Citation

  • Thaddeus L Miller & Scott J N McNabb & Peter Hilsenrath & Jotam Pasipanodya & Stephen E Weis, 2009. "Personal and Societal Health Quality Lost to Tuberculosis," PLOS ONE, Public Library of Science, vol. 4(4), pages 1-7, April.
  • Handle: RePEc:plo:pone00:0005080
    DOI: 10.1371/journal.pone.0005080
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    References listed on IDEAS

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    Cited by:

    1. Xinyi Chen & Wei Wang & Xiaomeng Wang & Chengliang Chai & Kui Liu & Ying Peng & Fei Wang & Bin Chen & Jianmin Jiang, 2019. "Public Awareness of Tuberculosis in Southeast China: A Population-Based Study," IJERPH, MDPI, vol. 16(21), pages 1-13, November.
    2. Alex J Goodell & Priya B Shete & Rick Vreman & Devon McCabe & Travis C Porco & Pennan M Barry & Jennifer Flood & Suzanne M Marks & Andrew Hill & Adithya Cattamanchi & James G Kahn, 2019. "Outlook for tuberculosis elimination in California: An individual-based stochastic model," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-15, April.
    3. Wanitchaya Kittikraisak & Pritaporn Kingkaew & Yot Teerawattananon & Jomkwan Yothasamut & Supalert Natesuwan & Weerawat Manosuthi & Virasakdi Chongsuvivatwong & Sara J Whitehead, 2012. "Health Related Quality of Life among Patients with Tuberculosis and HIV in Thailand," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-8, January.
    4. Julia S Louw & Musawenkosi Mabaso & Karl Peltzer, 2016. "Change in Health-Related Quality of Life among Pulmonary Tuberculosis Patients at Primary Health Care Settings in South Africa: A Prospective Cohort Study," PLOS ONE, Public Library of Science, vol. 11(5), pages 1-13, May.

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