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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Prioritising between direct observation of therapy and case-finding interventions for tuberculosis: Use of population impact measures
BMC Medicine, Volume 4, Article 35, Year 2006
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Description
Background: Population impact measures (PIMs) have been developed as tools to help policy-makers with locally relevant decisions over health risks and benefits. This involves estimating and prioritising potential benefits of interventions in specific populations. Using tuberculosis (TB) in India as an example, we examined the population impact of two interventions: direct observation of therapy and increasing case-finding. Methods: PIMs were calculated using published literature and national data for India, and applied to a notional population of 100 000 people. Data included the incidence or prevalence of smear-positive TB and the relative risk reduction from increasing case finding and the use of direct observation of therapy (applied to the baseline risks over the next year), and the incremental proportion of the population eligible for the proposed interventions. Results: In a population of 100 000 peo ple in India, the directly observed component of the Directly Observed Treatment, Short-course (DOTS) programme may prevent 0.188 deaths from TB in the next year compared with 1.79 deaths by increasing TB case finding. The costs of direct observation are (in international dollars) I$5960 and of case finding are I$4839 or I$31702 and I$2703 per life saved respectively. Conclusion: Increasing case-finding for TB will save nearly 10 times more lives than will the use of the directly observed component of DOTS in India, at a smaller cost per life saved. The demonstration of the population impact, using simple and explicit numbers, may be of value to policy-makers as they prioritise interventions for their populations. © 2006 Heller et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Heller, RF Frederick
United Kingdom, Manchester
The University of Manchester
Gemmell, Isla
United Kingdom, Manchester
The University of Manchester
Edwards, Richard E.
New Zealand, Dunedin
University of Otago
Buchan, Iain Edward
United Kingdom, Manchester
The University of Manchester
Awasthi, Shally K.
India, Lucknow
King George's Medical University
Volmink, Jimmy A.
South Africa, Cape Town
Stellenbosch University, Faculty of Medicine and Health Sciences
Statistics
Citations: 6
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1186/1741-7015-4-35
e-ISSN:
17417015
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Cohort Study