Research: Ahead of print: Public health impact and cost-effectiveness of screening for active tuberculosis disease or infection among children in South Africa

Professor Mark Hatherill has co-authored: "Public health impact and cost-effectiveness of screening for active tuberculosis disease or infection among children in South Africa" appearing in the Clinical Infectious Diseases journal. n this study the authors assessed the public health impact and cost-effectiveness of age-based routine screening and contact tracing in children in South Africa. 

In this study the authors assessed the public health impact and cost-effectiveness of age-based routine screening and contact tracing in children in South Africa. 

Study: Although tuberculosis disease is a leading cause of global childhood mortality, there remain major gaps in diagnosis, treatment and prevention in children, as tuberculosis control programs rely predominantly on presentation of symptomatic children or contact tracing.

In this study the authors assessed the public health impact and cost-effectiveness of age-based routine screening and contact tracing in children in South Africa. 

Methods: We used a deterministic mathematical model to evaluate age-based routine screening in 1-year increments from ages 0 to 5, with and without contact tracing and preventive treatment. Screening incorporated symptom history and tuberculin skin testing, with chest X-ray and GeneXpert Ultra for confirmatory testing. We projected tuberculosis cases, deaths, disability-adjusted life years (DALYs) and costs (2021 U.S. Dollars) and evaluated the incremental cost-effectiveness ratios (ICERs) comparing each intervention.

Routine screening for tuberculosis among young children combined with contact tracing and preventive treatment would have a large public health impact and be cost-effective in preventing pediatric tuberculosis deaths in high incidence settings like South Africa.

Routine screening for tuberculosis among young children combined with contact tracing and preventive treatment would have a large public health impact and be cost-effective in preventing pediatric tuberculosis deaths in high incidence settings like South Africa.