Abstract：
OBJECTIVE:To assess the cost-effectiveness of adding school based Mantoux screening programs to the New South Wales current TB prevention strategy. METHOD:A decision analysis model compared the costs and consequences of screening strategies against the current no-screen strategy. Costs associated with screening and with treating future cases of TB were considered. Consequences considered were deaths and adult cases of TB prevented. The study was based on data from prevalence surveys conducted in 1992 and 1994 in Central and South Western Sydney, New South Wales. Screening strategies considered were screening all or only overseas born (OSB) 6 year olds and all or only OSB 14 year olds in school settings. RESULTS:Screening 14 year olds prevented more deaths and adult cases of TB than screening 6 year olds for a similar cost. For both age groups targeted screening of OSB children was more cost-effective than screening all children. Targeted screening of 14 year olds--the most cost effective option--cost $17,956 (costs and benefits discounted at 5%) per adult case prevented, equivalent to approximately $130,000 per life year saved. The cost-effectiveness ratios decline substantially if lower discount rates and less conservative assumptions are applied. CONCLUSION:Targeted screening was more cost effective than screening all children, however, there are ethical implications of targeting a group based on their origin of birth. IMPLICATIONS:As prevention and control of TB continues to be a high priority for NSW, the implications of a school based screening program should be seriously considered.
journal_name
Aust N Z J Public Healthjournal_title
Australian and New Zealand journal of public healthauthors
Lowin A,Slater J,Hall J,Alperstein Gdoi
10.1111/j.1467-842x.2000.tb01564.xsubject
Has Abstractpub_date
2000-06-01 00:00:00pages
247-53issue
3eissn
1326-0200issn
1753-6405journal_volume
24pub_type
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