Anthony Ssebagereka¹*, Kyobutungi Victo¹, Stevens Kisaka¹ and Juliet N Sekandi^2,3

¹School of Public Health, College of Health Sciences, Makerere University, Uganda
²Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Georgia
³Global Health Institute, University of Georgia, Georgia

*Corresponding Author: Anthony Ssebagereka, School of Public Health, College of Health Sciences, Makerere University, Uganda.

Received: December 28, 2022; Published: January 18, 2023

Abstract

Objective: This study aims to evaluate the cost-effectiveness of a combination of three strategies compared to Passive Case Finding (PCF) alone for TB case identification among high-risk communities in Kampala from provider’s perspective.

Design: This was a cost effectiveness analysis where cost data and yield of TB cases for PCF alone and a combination of Passive Case Finding (PCF), Enhanced case finding strategies (ECF) and Household Contact Investigation (HCI) were collected among adults in highly-congested areas of Kampala. The main outcome was Incremental Cost Effectiveness Ratio representing the cost to detect an additional TB case identified.

Results: Based on Uganda TB program data, 4,755 pulmonary TB cases from 12,298 presumptive TB cases were identified through PCF alone in Kampala. The average cost for every presumptive tuberculosis case identified through PCF alone and PCF+HCI+ECF was US$895.80 and US$4909.90 respectively. The cost of detecting one additional TB case was US$8211.80 using PCF, ECF, and HCI compared to using PCF only. The Incremental Cost Effectiveness Ratio (ICER) was most sensitive to number of household contacts screened, number of TB cases identified through ECF and probability of having chronic cough.

Conclusion: The proportion of TB case yield of the combined strategies (PCF, ECF, and HCI) was twice as high as PCF alone. However, this was costlier making it less cost-effective compared to PCF alone based on the set threshold of twice Uganda’s gross domestic product.

Keywords: Cost Effectiveness Analysis; Pulmonary Tuberculosis; Enhanced Case Finding; Household Contacts; Passive Case Finding

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Citation

Citation: Anthony Ssebagereka., et al. “Combined Case Finding Strategies for Pulmonary Tuberculosis in Kampala City: A Cost Effectiveness Analysis”.Acta Scientific Medical Sciences 7.2 (2023): 83-91.

Copyright

Copyright: © 2022 Anthony Ssebagereka., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.