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Cost–effectiveness of screening for active cases of tuberculosis in Flanders, Belgium

Suzanne Smit UGent, Ludwig Apers, Wouter Arrazola de Onate, Philippe Beutels, Pierre Dorny UGent, An-Marie Forier, Kristien Janssens, Jean Macq, Ruud Mak, Sandrina Schol, et al. (2017) BULLETIN OF THE WORLD HEALTH ORGANIZATION. 95(1). p.27-35
abstract
OBJECTIVE: To assess the cost-effectiveness of the tuberculosis screening activities currently funded by the Flemish government in Flanders, Belgium. METHODS: After estimating the expenses for 2013-2014 of each of nine screening components - which include high-risk groups, contacts and people who are seeking tuberculosis consultation at a centre for respiratory health care - and the associated costs per active case of tuberculosis identified between 2007 and 2014, we compared the cost-effectiveness of each component. The applied perspective was that of the Flemish government. FINDINGS: The three most cost-effective activities appeared to be the follow-up of asylum seekers who were found to have abnormal X-rays in initial screening at the Immigration Office, systematic screening in prisons and contact investigation. The mean costs of these activities were 5564 (95% uncertainty interval, UI: 3791-8160), 11 603 (95% UI: 9010-14 909) and 13 941 (95% UI: 10 723-18 201) euros (€) per detected active case, respectively. The periodic or supplementary initial screening of asylum seekers and the screening of new immigrants from high-incidence countries - which had corresponding costs of €51 813 (95% UI: 34 855-76 847), €126 236 (95% UI: 41 984-347 822) and €418 359 (95% UI: 74 975-1 686 588) - appeared much less cost-effective. Between 2007 and 2014, no active tuberculosis cases were detected during screening in the juvenile detention centres. CONCLUSION: In Flanders, tuberculosis screening in juvenile detention centres and among new immigrants and the periodic or supplementary initial screening of asylum seekers appear to be relatively expensive ways of detecting people with active tuberculosis.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Public Health, Environmental and Occupational Health
journal title
BULLETIN OF THE WORLD HEALTH ORGANIZATION
Bull. World Health Organ.
volume
95
issue
1
pages
27 - 35
ISSN
0042-9686
DOI
10.2471/blt.16.169383
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
8500714
handle
http://hdl.handle.net/1854/LU-8500714
date created
2017-01-09 10:28:26
date last changed
2017-01-17 15:29:12
@article{8500714,
  abstract     = {OBJECTIVE: To assess the cost-effectiveness of the tuberculosis screening activities currently funded by the Flemish government in Flanders, Belgium.
METHODS: After estimating the expenses for 2013-2014 of each of nine screening components - which include high-risk groups, contacts and people who are seeking tuberculosis consultation at a centre for respiratory health care - and the associated costs per active case of tuberculosis identified between 2007 and 2014, we compared the cost-effectiveness of each component. The applied perspective was that of the Flemish government.
FINDINGS: The three most cost-effective activities appeared to be the follow-up of asylum seekers who were found to have abnormal X-rays in initial screening at the Immigration Office, systematic screening in prisons and contact investigation. The mean costs of these activities were 5564 (95\% uncertainty interval, UI: 3791-8160), 11 603 (95\% UI: 9010-14\,909) and 13 941 (95\% UI: 10 723-18 201) euros ({\texteuro}) per detected active case, respectively. The periodic or supplementary initial screening of asylum seekers and the screening of new immigrants from high-incidence countries - which had corresponding costs of {\texteuro}51 813 (95\% UI: 34 855-76 847), {\texteuro}126 236 (95\% UI: 41 984-347 822) and {\texteuro}418 359 (95\% UI: 74 975-1 686 588) - appeared much less cost-effective. Between 2007 and 2014, no active tuberculosis cases were detected during screening in the juvenile detention centres.
CONCLUSION: In Flanders, tuberculosis screening in juvenile detention centres and among new immigrants and the periodic or supplementary initial screening of asylum seekers appear to be relatively expensive ways of detecting people with active tuberculosis.},
  author       = {Smit, Suzanne and Apers, Ludwig and Arrazola de Onate, Wouter and Beutels, Philippe and Dorny, Pierre and Forier, An-Marie and Janssens, Kristien and Macq, Jean and Mak, Ruud and Schol, Sandrina and Wildemeersch, Dirk and Speybroeck, Niko and Devleesschauwer, Brecht},
  issn         = {0042-9686},
  journal      = {BULLETIN OF THE WORLD HEALTH ORGANIZATION},
  keyword      = {Public Health,Environmental and Occupational Health},
  language     = {eng},
  number       = {1},
  pages        = {27--35},
  title        = {Cost--effectiveness of screening for active cases of tuberculosis in Flanders, Belgium},
  url          = {http://dx.doi.org/10.2471/blt.16.169383},
  volume       = {95},
  year         = {2017},
}

Chicago
Smit, Suzanne, Ludwig Apers, Wouter Arrazola de Onate, Philippe Beutels, Pierre Dorny, An-Marie Forier, Kristien Janssens, et al. 2017. “Cost–effectiveness of Screening for Active Cases of Tuberculosis in Flanders, Belgium.” Bulletin of the World Health Organization 95 (1): 27–35.
APA
Smit, S., Apers, L., Arrazola de Onate, W., Beutels, P., Dorny, P., Forier, A.-M., Janssens, K., et al. (2017). Cost–effectiveness of screening for active cases of tuberculosis in Flanders, Belgium. BULLETIN OF THE WORLD HEALTH ORGANIZATION, 95(1), 27–35.
Vancouver
1.
Smit S, Apers L, Arrazola de Onate W, Beutels P, Dorny P, Forier A-M, et al. Cost–effectiveness of screening for active cases of tuberculosis in Flanders, Belgium. BULLETIN OF THE WORLD HEALTH ORGANIZATION. 2017;95(1):27–35.
MLA
Smit, Suzanne, Ludwig Apers, Wouter Arrazola de Onate, et al. “Cost–effectiveness of Screening for Active Cases of Tuberculosis in Flanders, Belgium.” BULLETIN OF THE WORLD HEALTH ORGANIZATION 95.1 (2017): 27–35. Print.