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  1. Modelling the economic benefits of tuberculosis preventive therapy for people with HIV : the example of Zambia.

    Article - En anglais

    Objective 

    To assess the economic benefits and costs of providing isoniazid preventive therapy for tuberculosis (TB) in HIV-infected persons in Zambia.

    Design 

    A spreadsheet model incorporating variables drawn from published studies and unpublished data.

    Subjects 

    Data drawn from a number of different studies and published literature involving a range of subjects.

    Setting 

    Zambia.

    Results 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0321772

    Code Inist : 002B06D01. Création : 12/09/1997.