ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Yield, Efficiency, and Costs of Mass Screening Algorithms for Tuberculosis in Brazilian Prisons.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
36 citing papers in PubMed, 4 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Epidemiology of TB in prisoners: a metanalysis of the prevalence of active and latent TB.BMC infectious diseases · 2023Pooled it
- Number needed to screen for TB in clinical, structural or occupational risk groups.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Pooled it
- Incidence and prevalence of tuberculosis in incarcerated populations: a systematic review and meta-analysis.The Lancet. Public health · 2021Pooled it
- Xpert MTB/RIF and Xpert Ultra assays for screening for pulmonary tuberculosis and rifampicin resistance in adults, irrespective of signs or symptoms.The Cochrane database of systematic reviews · 2021Pooled it
- Systematic review of the tuberculosis burden in prisons: Regional patterns and gaps in Latin America and the Caribbean.Global epidemiology · 2026Review
- Comparative impacts and cost-effectiveness of tuberculosis systematic screening strategies in prisons in Brazil, Colombia, and Peru: A mathematical modeling study.PLoS medicine · 2026Article
- Routine active case finding in Nigerian penitentiary institutions: comparing yields from digital X-ray with CAD4TB and WHO 4-symptom screening.BMC infectious diseases · 2026Article
- Tuberculosis in prisons: an integrated prevention and care cascade for a persistent structural epidemic.Frontiers in public health · 2026Review
- Article
- Evaluation of an ultra-portable X-ray system with automated interpretation for tuberculosis active case finding in carceral settings: a diagnostic test accuracy study.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
- The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise.medRxiv : the preprint server for health sciences · 2025Article
- Implementation costs and cost-effectiveness of ultraportable chest X-ray with artificial intelligence in active case finding for tuberculosis in Nigeria.PLOS digital health · 2025Article
- Tuberculosis Trends in the Post-COVID-19 Era: Is It Going to be a Global Concern?Health science reports · 2025Article
- Evaluation of an ultra-portable X-ray system with automated interpretation for tuberculosis active case finding in carceral settings: a diagnostic test accuracy study.Research square · 2025Article
- Global perspectives on tuberculosis in prisons and incarceration centers - Risk factors, priority needs, challenges for control and the way forward.IJID regions · 2025Review
- Symptom-Based Active Tuberculosis Screening in Two Nigerian Correctional Facilities: A Cross-Sectional Study.Le infezioni in medicina · 2025Article
- Comprehensive Tuberculosis Screening and Treatment at a Prison in Central Papua Province, Indonesia.Tropical medicine and infectious disease · 2024Article
- Cost-effectiveness and health impact of screening and treatment of Mycobacterium tuberculosis infection among formerly incarcerated individuals in Brazil: a Markov modelling study.The Lancet. Global health · 2024Article
- Prevalence and associated factors of TB and HIV coinfections among adult inmates with presumptive pulmonary TB in a Kenyan prison.Tropical medicine and health · 2024Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundTuberculosis (TB) is a major cause of morbidity and mortality among incarcerated populations globally. We performed mass TB screening in 3 prisons and assessed yield, efficiency, and costs associated with various screening algorithms.
methodsBetween 2017 and 2018, inmates from 3 prisons in Brazil were screened for TB by symptom assessment, chest radiography, sputum testing by Xpert MTB/RIF fourth-generation assay, and culture. Chest radiographs were scored by an automated interpretation algorithm (Computer-Aided Detection for Tuberculosis [CAD4TB]) that was locally calibrated to establish a positivity threshold. Four diagnostic algorithms were evaluated. We assessed the yield (percentage of total cases found) and efficiency (prevalence among those screened) for each algorithm. We performed unit costing to estimate the costs of each screening or diagnostic test and calculated the cost per case detected for each algorithm.
resultsWe screened 5387 prisoners, of whom 214 (3.9%) were diagnosed with TB. Compared to other screening strategies initiated with chest radiography or symptoms, the trial of all participants with a single Xpert MTB/RIF sputum test detected 74% of all TB cases at a cost of US$249 per case diagnosed. Performing Xpert MTB/RIF screening tests only on those with symptoms had a similar cost per case diagnosed (US$255) but missed 35% more cases (73 vs 54) as screening all inmates.
conclusionsIn this prospective study in 3 prisons in a high TB burden country, we found that testing all inmates with sputum Xpert MTB/RIF was a sensitive approach, while remaining cost-efficient. These results support use of Xpert MTB/RIF for mass screening in TB-endemic prisons.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.