ArticlemedRxiv : the preprint server for health sciences2025
Comparative impacts and cost-effectiveness of tuberculosis active case-finding strategies in prisons in Brazil, Colombia, and Peru: a mathematical modeling study.
Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
- Updated by
Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Incarceration is a leading driver of tuberculosis in Latin America. Active case-finding in prisons may reduce population-wide tuberculosis burden, but optimal strategies and cost-effectiveness remain uncertain. Methods and findings: Using dynamic transmission models calibrated to Brazil, Colombia, and Peru, we simulated annual or biannual (twice-yearly) prison-wide screening, alone or combined with entry and exit screening from 2026-2035. We evaluated four algorithms: 1) symptom screening, 2) chest X-ray with computer-aided detection (CXR-CAD), 3) symptoms and CXR-CAD (follow-up testing if either is positive) and 4) GeneXpert Ultra with pooled sputum. Individuals screening positive then received individual Xpert. We projected impacts on within-prison and population-level tuberculosis incidence in 2035, along with discounted costs (2023 USD) and disability-adjusted life years (DALYs). Model projections showed that combined entry, exit, and biannual screening with CXR-CAD was highly impactful and cost-effective across countries, reducing tuberculosis incidence by 62-87% in prisons and 18-28% population-wide. Compared to only biannual CXR-CAD (the next best strategy), the incremental cost per DALY averted of adding entry and exit screening was $2984 (Brazil), $2925 (Colombia), and $645 (Peru). Adding symptom screening to CXR-CAD marginally increased benefit and was only cost-effective in Peru's higher-incidence prisons. Biannual screening alone remained cost-effective at prison incidence levels well below national averages. In settings without CXR-CAD, pooled Xpert was an impactful, cost-effective alternative. Conclusions: These modeling results support immediate national-level adoption of prison-wide tuberculosis screening twice-yearly and at entry and exit. Screening should begin with available methods while building capacity for CXR-CAD, the most cost-effective algorithm.
Identifiers
What OpenQuestion holds
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.