Effectiveness and costeffectiveness of screening immigrants schemes for tuberculosis (TB) on arrival from high TB endemic countries to low TB prevalent countries

• Published in: African health sciences Vol. 14; no. 3; pp. 663 - 671
• Main Authors: Sanneh, A F N S, Al-Shareef, A M
• Format: Journal Article
• Language: English
• Published: Kampala Makerere Medical School 01.01.2014
• Subjects: Economics; Health and Medicine; Health Care Expenditures; Immigrants; Medical Screening; Tuberculosis
• ISSN: 1680-6905; 1680-6905; 1729-0503
• DOI: 10.4314/ahs.v14i3.23

Immigrants to developed countries are a major source of TB. Therefore amongst strategies adopted for TB control in developed countries include; 1) Screening immigrants at ports of entry referred to as "Port of Arrival Screening" (PoA) and 2) Passive screening (PS) for TB which means screening immigrants through general practices, hospitals, chest-clinics and emergency departments. Evidence of the effectiveness and cost effectiveness of these strategies is not consistent. Objective: Evaluate efficiency of active PoA TB screening for immigrants from TB endemic-regions compared with Passive Screening of immigrant-populations from TB endemic-regions. One cost effectiveness analysis was found that compared the costs of; active PoA screening, general practice screening and homeless screening groups. The cost of detecting a case of TB were; £1.26, £13.17and £96.36 for PS, homeless screening and active PoA screening respectively. The cost of preventing a case of TB were; £6.32, £23.00 and £10.00 for PS, homeless screening and PoA screening respectively, showing there is little difference between the different strategies. Conclusion: Active PoA screening is worth doing with significant benefits including early identification of risk groups with possible timely treatment/chemoprophylaxis intervention, prevention of transmission by significantly reducing infectiousness with subsequent avoidance of hospitalisation in active PoA screening group. [PUBLICATION ABSTRACT]