ArticleThe Lancet. Global health2024
Cost-effectiveness and health impact of screening and treatment of Mycobacterium tuberculosis infection among formerly incarcerated individuals in Brazil: a Markov modelling study.
Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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.
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Who cites it
5 citing papers in PubMed.
- Programmatic impact and cost-effectiveness of scaling up the short-course 3HP regimen for tuberculosis preventive treatment in Brazil.BMJ global health · 2026Article
- Health economic simulation modeling of an AI-enabled clinical decision support system for coronary revascularization.NPJ digital medicine · 2026Article
- Cost-effectiveness of preventive treatment regimens for latent tuberculosis infection among key community-level populations.BMC medicine · 2025Article
- Cost-effectiveness of tuberculosis infection screening at first reception into English prisons: a model-based analysis.EClinicalMedicine · 2025Article
- [The effect of the 3HP regimen on the completion of preventive tuberculosis treatment in people living with HIV: a retrospective cohort in Brazil].Cadernos de saude publica · 2025Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
backgroundIndividuals who were formerly incarcerated have high tuberculosis incidence, but are generally not considered among the risk groups eligible for tuberculosis prevention. We investigated the potential health impact and cost-effectiveness of Mycobacterium tuberculosis infection screening and tuberculosis preventive treatment (TPT) for individuals who were formerly incarcerated in Brazil.
methodsUsing published evidence for Brazil, we constructed a Markov state transition model estimating tuberculosis-related health outcomes and costs among individuals who were formerly incarcerated, by simulating transitions between health states over time. The analysis compared tuberculosis infection screening and TPT, to no screening, considering a combination of M tuberculosis infection tests and TPT regimens. We quantified health effects as reductions in tuberculosis cases, tuberculosis deaths, and disability-adjusted life-years (DALYs). We assessed costs from a tuberculosis programme perspective. We report intervention cost-effectiveness as the incremental costs per DALY averted, and tested how results changed across subgroups of the target population.
findingsCompared with no intervention, an intervention incorporating tuberculin skin testing and treatment with 3 months of isoniazid and rifapentine would avert 31 (95% uncertainty interval 14-56) lifetime tuberculosis cases and 4·1 (1·4-5·8) lifetime tuberculosis deaths per 1000 individuals, and cost US$242 per DALY averted. All test and regimen combinations were cost-effective compared with no screening. Younger age, longer incarceration, and more recent prison release were each associated with significantly greater health benefits and more favourable cost-effectiveness ratios, although the intervention was cost-effective for all subgroups examined.
interpretationM tuberculosis infection screening and TPT for individuals who were formerly incarcerated appears cost-effective, and would provide valuable health gains.
fundingNational Institutes of Health. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.
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