Evidence map›Paper›PMID 40674508›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025

Projecting the Impact and Costs of Near Point-of-Care Tuberculosis Screening Assays in Community-based Active Case Finding.

Jason R Andrews, Emily A Kendall, Adithya Cattamanchi, Claudia M Denkinger, Payam Nahid, Sourya Shrestha, Florian M Marx, David Dowdy, Sabine Hermans, Frank Cobelens

Registry-linked trialAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07420881 (Start 4 All - DARE-TB), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT07420881 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Start 4 All - DARE-TB

TypeinterventionalSponsorLiverpool School of Tropical MedicineRan2026 to 2027Enrolled60,000ConditionsTB - TuberculosisArmsNear point of care (NPOC) NAATs, Low-complexity nucleic acid amplification tests (LC-NAATs), LC-NAAT using pooled testing, Computer-Aided Detection (CAD) Chest X-ray (CXR-AI), Culture (reference standard)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jason R AndrewsDepartment of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Emily A KendallDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Adithya CattamanchiDivision of Pulmonary Diseases and Critical Care Medicine, UC Irvine, Irvine, California, USA.
Claudia M DenkingerDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Payam NahidUCSF Center for Tuberculosis, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0003-2811-1311
Sourya ShresthaDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Florian M MarxDepartment of Infectious Disease and Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.ORCID 0000-0003-4630-4598
David DowdyDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Sabine HermansDepartment of Global Health and Amsterdam Public Health, Amsterdam University Medical Centers Location University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0001-5146-2932
Frank CobelensDepartment of Global Health and Amsterdam Public Health, Amsterdam University Medical Centers Location University of Amsterdam, Amsterdam, The Netherlands.

Funding

Rapid Research for Diagnostics Development in TB Network (R2D2 TB Network)U01AI152087 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CATTAMANCHI, ADITHYA, DENKINGER, CLAUDIA MARIA · 2020 to 2024
$19.3M
Strategies for tuberculosis control in prisonsR01AI130058 · NIAID · STANFORD UNIVERSITY · PI Jason Randolph Andrews, Julio Henrique Rosa Croda · 2017 to 2026
$5.8M
Mentoring patient-oriented translational research in tuberculosisK24AI182647 · NIAID · STANFORD UNIVERSITY · PI Jason Randolph Andrews · 2024 to 2026
$512k
NIAID NIH HHS U01 AI152087NIH HHS K24 AI182647NIH HHS R01 AI130058
6 · The paper itself

Abstract

backgroundCommunity-based active case finding (ACF) may reduce tuberculosis incidence and mortality but is not widely implemented due to resource constraints. How novel screening test characteristics would affect the impact and costs of ACF strategies is not clear.

methodsWe developed mathematical models of tuberculosis natural history and transmission, calibrated to data from 3 high tuberculosis burden countries (India, Vietnam, and the Philippines) and simulated the impact of annual community-based ACF programs. We compared annual screening, with or without an initial symptom screen, for 10 years with 2 hypothetical screening assays based on target product profile minimum targets: a low complexity (reaches 60% of the population) test with high sensitivity (90%) and moderate specificity (80%) costing $3; and a near point-of-care (reaches 80% of the population) test with moderate sensitivity (55%) and high specificity (98%) costing $2. We projected reductions in tuberculosis incidence, mortality, and costs under each scenario.

resultsAnnual screening with a low-complexity, high-sensitivity screening assay was projected to reduce tuberculosis mortality by 24%-38%, at an annual cost of $5.04-$5.83 per capita. Annual screening with a near-point-of-care, moderate-sensitivity assay was projected to achieve comparable reductions in mortality (24%-42%) at $3.49-$3.63 per capita. Symptom-based screening would yield more modest reductions in tuberculosis mortality (17%-24%) at an annual cost of around $1 per capita.

conclusionsNear point-of-care, moderate-sensitivity screening assays for tuberculosis could achieve substantial impact on tuberculosis mortality-equivalent to that of high-sensitivity assays and at lower cost-if they can be performed at scale in community settings.

Indexed as

Mass ScreeningPoint-of-Care SystemsPoint-of-Care TestingTuberculosisHumansIncidenceIndiaModels, TheoreticalPhilippinesSensitivity and SpecificityVietnamcase findingcommunity-baseddiagnosticsscreeningtuberculosis

Identifiers

PMID40674508
PMCPMC12596382

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Registered trials

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.