Census versus High-risk Population Screening for Tuberculosis in Mianyan City: A Health Economics Evaluation_Chinese Journal of Evidence-Based Medicine

Authors：

 HUANGWei-wei ,  HEJian-qing

Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

HEJian-qing, Email: jianqhe@gmail.com

Keywords：

Census; High-risk population screening; Tuberculosis; Cost-utility ratio; Benefit-cost ratio; Health economics

DOI：

10.7507/1672-2531.20160040

Video：

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Objective To evaluate the effect of health economics of census versus high-risk population screening for tuberculosis in Mianyan city, in order to provide references for the selection of suitable tuberculosis screening method in western region of China. Methods We included active tuberculosis patients by residents health screening of 21 villages and towns in Mianyan city from June 2013 to March 2013. Relevant data was analyzed by referencing the National Assessment of Tuberculosis Control Program in 2001-2010. Results 184047 residents were screened by tuberculosis census and 128 active tuberculosis patients were diagnosed while 61045 residents were screened by high-risk population screening and 76 active tuberculosis patients were diagnosed. The cost-utility ratio and benefit-cost ratio of tuberculosis census were 6174.17 and 3.84, respectively. The cost-utility ratio and benefit-cost ratio of high risk population screening were 3106.16 and 7.62, respectively. Conclusion High-risk population screening has higher cost-utility ratio and benefit-cost ratio than tuberculosis census with higher missed diagnosis. Benefits and harms of tuberculosis detection rate and cost should be fully balanced before tuberculosis screening method were chosen in western underdeveloped region of China.

Citation： HUANGWei-wei, HEJian-qing. Census versus High-risk Population Screening for Tuberculosis in Mianyan City: A Health Economics Evaluation. Chinese Journal of Evidence-Based Medicine, 2016, 16(3): 249-253. doi: 10.7507/1672-2531.20160040 Copy

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6.	王宏. 结核病防治DOTS方案的经济学评价. 中国卫生经济杂志, 2009, 28(4):27-28.
7.	许群. 初治涂阳肺结核病人DOTS和非DOTS干预的成本-效果分析. 中国防痨杂志, 2000, 22(2):60-62.
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12.	Byrne AL, Marais BJ, Mitnick CD, et al. Tuberculosis and chronic respiratory disease:a systematic review. Int J Infect Dis, 2015, 32(3):138-146.
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14.	Ma L, Lin B, Wang L, et al. Preventive therapy for iatrogenic active tuberculosis in systemic lupus erythematosus patients. Zhonghua Yi Xue Za Zhi, 2014, 94(45):3579-3582.
15.	姜伟, 黄莉芳. 全民健康普查在肺结核主动发现中的作用研究. 现代预防医学, 2012, 39(12):3102-3103, 3105.
16.	中华人民共和国卫生部. WS288-2008肺结核诊断标准. 北京:人民卫生出版社, 2008.
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18.	许群, 乌正赉, 金水高, 等. 初治涂阳肺结核病人及其传染性所致疾病负担的评价方法研究. 卫生研究, 2003, 32 (6):558-561.
19.	马艳, 成诗明, 周林. 涂阴肺结核诊断和治疗进展. 中国健康教育, 2008, 24 (6):451-455.
20.	王陇德. 结核病防治. 第1版. 北京:中国协和医科大学出版社, 2004.
21.	卫生统计信息中心. 中国卫生服务调查研究第三次国家卫生服务调查分析报告. 北京:中国协和医科大学出版社, 2004.
22.	龚幼龙, 万利亚, 武桂英. 结核病控制经济与管理学评价. 第1版. 上海:第二军医大学出版社, 2003:373-374.
23.	李岚, 卢和平. 结核患者用药依从性及影响因素调查. 临床医药实践, 2010, 19(4):506-507.
24.	唐琴, 冯艳萍, 冯先惠. 门诊健康教育对结核患者治疗依从性的影响. 2013, 10(14):1898-1899.
25.	沈建恩, 雷涛, 王祖恩. 肺结核病人化疗依从性相关因素研究. 中国防痨杂志, 2007, 29(2):133-135.
26.	Craig GM, Joly LM, Zumla A. ‘Complex’ but coping:experience of symptoms of tuberculosis and health care seeking behaviours-a qualitative interview study of urban risk groups, London, UK. BMC Public Health, 2014, 14(6):618.

1. 万康林. 中国结核病流行新特点及挑战. 疾控监测, 2008, 23(11):667-670.
2. 卫生部疾病预防控制局. 中国结核病防治规划实施工作指南(2008年版). 北京:中国协和医科大学出版社, 2009.
3. 全国第五次结核病流行病学抽样调查技术指导组/全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8):485-508.
4. Rhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis, 2013, 93(1):104-107.
5. 李建伟, 钟球, 黄桂清, 等. 不同人群筛查肺结核病人的效果评价. 中国防痨杂志, 2004, 26(3):136-138.
6. 王宏. 结核病防治DOTS方案的经济学评价. 中国卫生经济杂志, 2009, 28(4):27-28.
7. 许群. 初治涂阳肺结核病人DOTS和非DOTS干预的成本-效果分析. 中国防痨杂志, 2000, 22(2):60-62.
8. 王芸, 许琳, 邱玉冰, 等. 主动筛查方式下云南省6个偏远农村肺结核患病情况分析. 现代预防医学, 2014, 41(19):3606-3608.
9. Negin J, Abimbola S, Marais BJ. Tuberculosis among older adults-time to take notice. Int J Infect Dis, 2015, 32(3):135-137.
10. Curtis J. Impact of x-ray screening programmes for active tuberculosis in homeless populations:a systematic review of original studies. J Public Health (Oxf), 2016, 38(1):106-114.
11. Chiang CY, Bai KJ, Lin HH, et al. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PLoS One, 2015, 10(3):e0121698.
12. Byrne AL, Marais BJ, Mitnick CD, et al. Tuberculosis and chronic respiratory disease:a systematic review. Int J Infect Dis, 2015, 32(3):138-146.
13. Alavi SM, Bakhtiarinia P, Eghtesad M, et al. A comparative study on the prevalence and risk factors of tuberculosis among the prisoners in khuzestan, South-west iran. Jundishapur J Microbiol, 2014, 7(12):e18872.
14. Ma L, Lin B, Wang L, et al. Preventive therapy for iatrogenic active tuberculosis in systemic lupus erythematosus patients. Zhonghua Yi Xue Za Zhi, 2014, 94(45):3579-3582.
15. 姜伟, 黄莉芳. 全民健康普查在肺结核主动发现中的作用研究. 现代预防医学, 2012, 39(12):3102-3103, 3105.
16. 中华人民共和国卫生部. WS288-2008肺结核诊断标准. 北京:人民卫生出版社, 2008.
17. 卫生部办公厅. 关于开展《全国结核病防治规划(2001-2010年)》终期评估的通知. Available at:http://www.moh.gov.cn/jkj/s3589/201009/946689dd09924a509b0c6f9f86169548.shtml.
18. 许群, 乌正赉, 金水高, 等. 初治涂阳肺结核病人及其传染性所致疾病负担的评价方法研究. 卫生研究, 2003, 32 (6):558-561.
19. 马艳, 成诗明, 周林. 涂阴肺结核诊断和治疗进展. 中国健康教育, 2008, 24 (6):451-455.
20. 王陇德. 结核病防治. 第1版. 北京:中国协和医科大学出版社, 2004.
21. 卫生统计信息中心. 中国卫生服务调查研究第三次国家卫生服务调查分析报告. 北京:中国协和医科大学出版社, 2004.
22. 龚幼龙, 万利亚, 武桂英. 结核病控制经济与管理学评价. 第1版. 上海:第二军医大学出版社, 2003:373-374.
23. 李岚, 卢和平. 结核患者用药依从性及影响因素调查. 临床医药实践, 2010, 19(4):506-507.
24. 唐琴, 冯艳萍, 冯先惠. 门诊健康教育对结核患者治疗依从性的影响. 2013, 10(14):1898-1899.
25. 沈建恩, 雷涛, 王祖恩. 肺结核病人化疗依从性相关因素研究. 中国防痨杂志, 2007, 29(2):133-135.
26. Craig GM, Joly LM, Zumla A. ‘Complex’ but coping:experience of symptoms of tuberculosis and health care seeking behaviours-a qualitative interview study of urban risk groups, London, UK. BMC Public Health, 2014, 14(6):618.

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