ArticlePublic health action2019
A comparison of the yield and relative cost of active tuberculosis case-finding algorithms in Zimbabwe.
Article in Public health action, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review.BMC infectious diseases · 2021Pooled it
- Comparative impacts and cost-effectiveness of tuberculosis systematic screening strategies in prisons in Brazil, Colombia, and Peru: A mathematical modeling study.PLoS medicine · 2026Article
- Active TB case finding in returnee coalminers and their home district communities in Pakistan.Public health action · 2025Article
- The health impact of identifying a person with tuberculosis through systematic screening.The Lancet. Infectious diseases · 2025Review
- Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: an epidemiological modeling analysis.BMC infectious diseases · 2025Article
- Comparative impacts and cost-effectiveness of tuberculosis active case-finding strategies in prisons in Brazil, Colombia, and Peru: a mathematical modeling study.medRxiv : the preprint server for health sciences · 2025Article
- Iterative evaluation of mobile computer-assisted digital chest x-ray screening for TB improves efficiency, yield, and outcomes in Nigeria.PLOS global public health · 2024Article
- Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria.Public health action · 2022Article
- Comparison of yield and relative costs of different screening algorithms for tuberculosis in active case-finding: a cross-section study.BMC infectious diseases · 2021Article
- Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study.Tuberculosis research and treatment · 2021Article
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Abstract
settingTen districts and three cities in Zimbabwe.
objectiveTo compare the yield and relative cost of identifying a case of tuberculosis (TB) using the three WHO-recommended algorithms (WHO2b, symptom inquiry only; WHO2d, chest X-ray [CXR] after a positive symptom inquiry; WHO3b, CXR only) and the Zimbabwe active case finding (ZimACF) algorithm (symptom inquiry plus CXR) to everyone.
designCross-sectional study using data from the ZimACF project.
resultsA total of 38 574 people were screened from April to December 2017; 488 (1.3%) were diagnosed with TB using the ZimACF algorithm. Fewer TB cases would have been diagnosed with the WHO-recommended algorithms. This ranged from 7% fewer (34 cases) with WHO3b, 18% fewer (88 cases) with WHO2b and 25% fewer (122 cases) with WHO2d. The need for CXR ranged from 36% (WHO2d) to 100% (WHO3b). The need for bacteriological confirmation ranged from 7% (WHO2d) to 40% (ZimACF). The relative cost per case of TB diagnosed ranged from US$180 with WHO3b to US$565 for the ZimACF algorithm.
conclusionThe ZimACF algorithm had the highest case yield, but at a much higher cost per case than the WHO algorithms. It is possible to switch to algorithm WHO3b, but the trade-off between cost and yield needs to be reviewed by the Zimbabwean National TB Programme.
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