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Tuberculosis control priorities defined by using cost-effectiveness and burden of disease
Authors:Xu Qun  Wu Zheng-Lai  Jin Shui-Gao  Zhang Li-Xing
Affiliation:1. Department of Epidemiology, Institute of Basic Medical Sciences, Chinese Academy ofMedical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100005, China;2. Information Center for Public Health, Chinese Academy of Preventive Medicine, Beijing 100050, China;3. Beijing ResearchInstitute for TB Control, Beijing 100035, China
Abstract:Objective To define TB control priorities using cost-effectiveness and burden of disease.Methods An assumed cohort of 2 000 cases was set up based on age-specific incidence of 794 newly registered smear-positive cases in Beijing in1994.Prognostic trees and model diagrams of infectivity with natural history and DOTS intervention were constructed based on the epidemiological parameters.Results DOTS reduced 89.19% of YLL,78.90% of YLD,and 99.98% of infectivity BOD.One DALY could be saved with 45.70% Yuan by DOTS with 3% discount.Sensitivity analysis showed that discount had effect on CER.Weight of age was insensitive to CER.The higher the DOTS coured rate,the more the cost-effectiveness.Conclusions DOTS is a good cost-effectiveness TB control strategy.Cost-effectiveness and burden of disease can be used to define TB control priorities.
Keywords:Tuberculosis(TB)  Burden of disease(BOD)  Disability adjusted life year(DALY)  Cost-effectiveness ratio(CER)
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