Trade-offs between cost and accuracy in active case finding for tuberculosis: A dynamic modelling analysis.

ABSTRACT:

Background

Active case finding (ACF) may be valuable in tuberculosis (TB) control, but questions remain about its optimum implementation in different settings. For example, smear microscopy misses up to half of TB cases, yet is cheap and detects the most infectious TB cases. What, then, is the incremental value of using more sensitive and specific, yet more costly, tests such as Xpert MTB/RIF in ACF in a high-burden setting?

Methods and findings

We constructed a dynamic transmission model of TB, calibrated to be consistent with an urban slum population in India. We applied this model to compare the potential cost and impact of 2 hypothetical approaches following initial symptom screening: (i) 'moderate accuracy' testing employing a microscopy-like test (i.e., lower cost but

SUBMITTER: Cilloni L 

PROVIDER: S-EPMC7710036 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature