Hamada, Y;
Mukora, R;
Pelusa, R;
Ntshiqa, T;
Shedrawy, J;
Velen, K;
Abubakar, I;
... Rangaka, MX; + view all
(2025)
Costs and cost-effectiveness of integrated screening for non-communicable diseases in TB contacts.
IJTLD Open
, 2
(3)
pp. 160-165.
10.5588/ijtldopen.24.0625.
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Abstract
BACKGROUND: Integrating non-communicable disease (NCD) screening into TB household contact investigations may identify undiagnosed NCDs and reduce the burden of both conditions. However, evidence on the costs and cost-effectiveness of this approach is limited. METHOD: We conducted a cross-sectional study in South Africa to assess patient and provider costs for NCD screening (hypertension, diabetes, chronic kidney disease, dyslipidaemia). Incremental costs per NCD case identified were calculated. Using a decision tree model, we estimated incremental costs per disability-adjusted life year (DALY) averted over 10 years from a healthcare perspective, with cardiovascular disease (CVD) risk estimated using the WHO prediction model. RESULTS: The incremental cost was USD72.3 per contact screened and USD334.0 per NCD case identified. Integrated screening reduced mean 10-year CVD risk from 5.7% to 2.7% among contacts with NCDs. The incremental cost-effectiveness ratio (ICER) was USD27,043.6 per DALY averted, exceeding South Africa's threshold of USD3,708. Management of identified NCDs, mainly drug costs, comprised over 80% of total incremental costs. The ICER decreased in populations with a high risk for NCDs. CONCLUSION: Integrated NCD screening was not cost-effective, mainly due to subsequent care costs. Prioritising individuals at high risk for NCDs can improve cost-effectiveness.
| Type: | Article |
|---|---|
| Title: | Costs and cost-effectiveness of integrated screening for non-communicable diseases in TB contacts |
| Location: | France |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.5588/ijtldopen.24.0625 |
| Publisher version: | https://doi.org/10.5588/ijtldopen.24.0625 |
| Language: | English |
| Additional information: | This article is Open Access under the terms of the Creative Commons CC BY licence. https://creativecommons.org/licenses/by/4.0/ |
| Keywords: | chronic diseases, contact investigation, economic analysis, integration, tuberculosis |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10206510 |
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