ArticlePloS one2015
Cost-effectiveness analysis of community active case finding and household contact investigation for tuberculosis case detection in urban Africa.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Treatment completion and safety profile of once-weekly 3HP regimen for tuberculosis preventive treatment in children and adolescents: a systematic review.BMC infectious diseases · 2025Pooled it
- Inclusion of Additional Unintended Consequences in Economic Evaluation: A Systematic Review of Immunization and Tuberculosis Cost-Effectiveness Analyses.PharmacoEconomics - open · 2021Pooled it
- Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review.BMC infectious diseases · 2021Pooled it
- A Systematic Review of Methodological Variation in Healthcare Provider Perspective Tuberculosis Costing Papers Conducted in Low- and Middle-Income Settings, Using An Intervention-Standardised Unit Cost Typology.PharmacoEconomics · 2020Pooled it
- Cost-effectiveness of integrating paediatric tuberculosis services into child healthcare services in Africa: a modelling analysis of a cluster-randomised trial.BMJ global health · 2024Trial
- Detect early TB infection, evaluate contacts for TB (DETEC-TB) - a protocol for a prospective cohort study on active case finding for tuberculosis disease and tuberculosis infection source tracing.BMC infectious diseases · 2025Article
- The health impact of identifying a person with tuberculosis through systematic screening.The Lancet. Infectious diseases · 2025Review
- A cost-effectiveness analysis of novel stool processing methods for diagnosis of tuberculosis in children under 5 years of age in Uganda.BMC health services research · 2025Article
- Using sputum and tongue swab specimens for in-home point-of-care targeted universal testing for tuberculosis of household contacts: an acceptability and feasibility analysis.BMJ global health · 2025Article
- Cost-effectiveness of adding measurement of Chlamydia trachomatis infection and serology to trachoma prevalence surveys in Tanzania and Mozambique.PLoS neglected tropical diseases · 2025Article
- Innovative timing strategies for tuberculosis household contact investigation: cost-effectiveness analysis from a randomized trial in rural and urban South Africa (Kharituwe Study).EClinicalMedicine · 2025Article
- Tuberculosis Preventive Treatment in High TB-Burden Settings: A State-of-the-Art Review.Drugs · 2025Review
- Article
- Cachexia in tuberculosis in South-East Asian and African regions: knowledge gaps and untapped opportunities.Annals of medicine and surgery (2012) · 2024Review
- 3HP preventive treatment among children and adolescents with HIV and child household contacts of TB patients.IJTLD open · 2024Article
- Ensuring Continuity of Tuberculosis Care during Social Distancing through Integrated Active Case Finding at COVID-19 Vaccination Events in Vietnam: A Cohort Study.Tropical medicine and infectious disease · 2024Article
- Missed opportunity for tuberculosis screening among patients presenting at two health facilities in Manafwa district, Uganda.Journal of public health in Africa · 2023Article
- mHealth to improve implementation of TB contact investigation: a case study from Uganda.Implementation science communications · 2023Article
- Cost to perform door-to-door universal sputum screening for TB in a high-burden community.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2023Article
- Exhaled Mycobacterium tuberculosis Predicts Incident Infection in Household Contacts.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionCase detection by passive case finding (PCF) strategy alone is inadequate for detecting all tuberculosis (TB) cases in high burden settings especially Sub-Saharan Africa. Alternative case detection strategies such as community Active Case Finding (ACF) and Household Contact Investigations (HCI) are effective but empirical evidence of their cost-effectiveness is sparse. The objective of this study was to determine whether adding ACF or HCI compared with standard PCF alone represent cost-effective alternative TB case detection strategies in urban Africa.
methodsA static decision modeling framework was used to examine the costs and effectiveness of three TB case detection strategies: PCF alone, PCF+ACF, and PCF+HCI. Probability and cost estimates were obtained from National TB program data, primary studies conducted in Uganda, published literature and expert opinions. The analysis was performed from the societal and provider perspectives over a 1.5 year time-frame. The main effectiveness measure was the number of true TB cases detected and the outcome was incremental cost-effectiveness ratios (ICERs) expressed as cost in 2013 US$ per additional true TB case detected.
resultsCompared to PCF alone, the PCF+HCI strategy was cost-effective at US$443.62 per additional TB case detected. However, PCF+ACF was not cost-effective at US$1492.95 per additional TB case detected. Sensitivity analyses showed that PCF+ACF would be cost-effective if the prevalence of chronic cough in the population screened by ACF increased 10-fold from 4% to 40% and if the program costs for ACF were reduced by 50%.
conclusionsUnder our baseline assumptions, the addition of HCI to an existing PCF program presented a more cost-effective strategy than the addition of ACF in the context of an African city. Therefore, implementation of household contact investigations as a part of the recommended TB control strategy should be prioritized.
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