Scaling up investigation and treatment of household contacts of tuberculosis patients in Brazil: a cost-effectiveness and budget impact analysis

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dc.contributor.authorBastos, Mayara Lisboa
dc.contributor.authorOxlade, Olivia
dc.contributor.authorCampbell, Jonathon R.
dc.contributor.authorFaerstein, Eduardo
dc.contributor.authorMenzies, Dick
dc.contributor.authorTrajman, Anete
dc.date.accessioned2024-12-10T18:32:34Z
dc.date.available2024-12-10T18:32:34Z
dc.date.issued2022
dc.description.abstractBackground: In Brazil, investigation and treatment of tuberculosis infection (TBI) in households contacts (HHC) of TB patients is not a priority. We estimated the cost-effectiveness and budget-impact of scaling-up an enhanced HHC management in Brazil. Methods: We conceptualized a cascade-of-care that captures how HHC of tuberculosis patients are investigated in Brazil (status quo) and two enhanced strategies for management of HHC focusing on: (1) only tuberculosis disease (TBD) detection and, (2) TBD and TBI detection and treatment. Effectiveness was the number of HHC diagnosed with TBD and completing TBI treatment. Proportions in the cascades-of-care were derived from a meta-analysis. Health-system costs (2019 US$) were based on literature and official data from Brazil. The impact of enhanced strategies was extrapolated using reported data from 2019. Findings: With the status quo, 0 (95% uncertainty interval: 0-1) HHC are diagnosed with TBD and 2 (0-16) complete TBI treatment. With strategy(1), an additional 15 (3-45) HHC would be diagnosed with TBD at a cost of US$346 each. With strategy(2), 81 (19-226) additional HHC would complete TBI treatment at a cost of US$84 each. A combined strategy, implemented nationally to enhance TBD detection and TBI treatment would result in an additional 9,711 (845-28,693) TBD being detected, and 51,277 (12,028-143,495) more HHC completing TBI treatment each year, utilizing 10.9% and 11.6% of the annual national tuberculosis program budget, respectively. Interpretation: Enhanced detection and treatment of TBD and TBI among HHC in Brazil can be achieved at a national level using current tools at reasonable cost. Funding: None.
dc.identifier.citationBastos ML, Oxlade O, Campbell JR, Faerstein E, Menzies D, Trajman A. Scaling up investigation and treatment of household contacts of tuberculosis patients in Brazil: a cost-effectiveness and budget impact analysis. Lancet Reg Health Am. 2022 Jan 10;8:100166. doi: 10.1016/j.lana.2021.100166.
dc.identifier.otherDOI: 10.1016/j.lana.2021.100166
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/693
dc.language.isoen
dc.publisherThe Lancet Regional Health - Americas
dc.subjectBrazilen
dc.subjectTuberculosisen
dc.subjectLatent tuberculosisen
dc.subjectCascade-of-careen
dc.subjectcost-effectivenessen
dc.subjectbudget impacten
dc.subjecttuberculosis preventive therapy.en
dc.titleScaling up investigation and treatment of household contacts of tuberculosis patients in Brazil: a cost-effectiveness and budget impact analysis
dc.typeArticle
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