Modelling the economic benefits of tuberculosis preventive therapy for people with HIV : the example of Zambia.
To assess the economic benefits and costs of providing isoniazid preventive therapy for tuberculosis (TB) in HIV-infected persons in Zambia.
A spreadsheet model incorporating variables drawn from published studies and unpublished data.
Data drawn from a number of different studies and published literature involving a range of subjects.
Using data primarily from Zambia we have modelled the costs and benefits of a TB preventive therapy programme using daily isoniazid for 6 months.
The base-case scenario assumes recruitment at a voluntary testing and counselling site where HIV seroprevalence is 30% ; persons with HIV have a 25% probability of developing active TB during their lifetime ; two additional cases of TB would be prevented per person completing a course of preventive therapy ; compliance would be 63%, and the efficacy of the isoniazid in preventing active TB of 60%. The costs under this scenario would exceed the benefits by a factor of 1.16 [benefit :
The base-case scenario assumes recruitment at a voluntary testing and counselling site where HIV seroprevalence is 30% ;
persons with HIV have a 25% probability of developing active TB during their lifetime ;
two additional cases of TB would be prevented per person completing a course of preventive therapy ;
cost ratio (BCR) of 0.86]. However, if preventing one case of TB prevented an additional five cases, the benefits would exceed the costs by a significant margin (BCR of 1.71).
Other scenarios indicate that the targeted preventive therapy of persons with HIV whose occupation or living situation places them in contact with a large number of others (teachers and students, health personnel, military and police, miners, prisoners, etc. (...)
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Chimioprophylaxie, Antituberculeux, SIDA, Virose, Infection opportuniste, Analyse avantage coût, Prévention, Homme, Coût, Zambie, Afrique, Isoniazide, Economie santé, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Chemoprophylaxis, Antituberculous agent, AIDS, Viral disease, Opportunistic infection, Cost benefit analysis, Prevention, Human, Costs, Zambia, Africa, Isoniazid, Health economy, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0321772
Code Inist : 002B06D01. Création : 12/09/1997.