Costs of providing tuberculosis diagnosis and treatment services in Viet Nam

Minh, Hoàng Văn; Q, V; Nhung, Nguyen Viet; Hoi, Le Van; Giang, Kim Bảo; Chung, Li-Yu; Kien, Vu Duy; Duyen, Nguyen Thuy; Nguyen, Ngoc Binh; Anh, Trần Thị Vân; Phuong, Tran Bich; Ngan, Tran Thu; Khanh, Pham Huyen

doi:10.5588/ijtld.16.0778

Cited by 7 publications

(9 citation statements)

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“…Therefore, the government should formulate more policies to benefit the people, especially in rural areas, to promote the economic development of rural areas and alleviate poverty. More importantly, the government should increase spending on medicine and health care especially in the economically backward countryside, and actively screen for suspicious TB cases to effectively reduce the TB incidence [15,16].…”

Section: Discussionmentioning

confidence: 99%

Association between economic development level and tuberculosis registered incidence in Shandong, China

et al. 2020

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Background Tuberculosis (TB) is one of the major infectious diseases that seriously endanger people’s health. In Shandong province, the relationship between the level of economic development and TB incidence has not been studied. This study aims to provide more research basis for the government to prevent and control TB by exploring the impact of different economic factors on TB incidence. Methods By constructing threshold regression model (TRM), we described the extent to which different economic factors contribute to TB registered incidence and differences in TB registered incidence among seventeen cities with different levels of economic development in Shandong province, China, during 2006–2017. Data were retrieved from the China Information System for Disease Control and Prevention. Results Per capita medical expenditure (regression coefficient, -0.0314462; SD, 0.0079305; P > |t|, 0.000) and per capita savings (regression coefficient, 0.0001924; SD, 0.0000566; P > |t|, 0.001) passed the significance test at the level of 1%.They are the two economic indicators that have the greatest impact on TB registered incidence. Through the threshold test, we selected the per capita savings as the threshold variable. In the three stages of per capita savings (<9772.8086 China Yuan(CNY); 9772.8086–33,835.5391 CNY; >33,835.5391 CNY), rural per capita income always has a significant negative impact on the TB registered incidence (The regression coefficients are − 0.0015682, − 0.0028132 and − 0.0022253 respectively. P is 0.007,0.000 and 0.000 respectively.).In cities with good economies, TB registered incidence was 38.30% in 2006 and dropped to 25.10% by 2017. In cities with moderate economies, TB registered incidence peaked in 2008 at 43.10% and dropped to 27.1% by 2017.In poorer cities, TB registered incidence peaked in 2008 at 56.30% and dropped to 28.9% in 2017. Conclusion We found that per capita savings and per capita medical expenditure are most closely related to the TB incidence. Therefore, relevant departments should formulate a more complete medical system and medical insurance policy to effectively solve the problem of “difficult and expensive medical treatment”. In order to further reduce the TB incidence, in addition to timely and accurate diagnosis and treatment, it is more important for governments to increase investment in medicine and health care.

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Section: Discussionmentioning

confidence: 99%

Association between economic development level and tuberculosis registered incidence in Shandong, China

et al. 2020

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“…Analyses of the health system costs of contact screening and diagnosing and treating tuberculosis infection from Uganda, Malaysia, and Vietnam suggest that this is a highly feasible target. 22 , 23 , 24 If in a particular setting the costs of intervention exceed this amount, then a priority task becomes how to deliver the necessary interventions more efficiently.…”

Section: Discussionmentioning

confidence: 99%

Potential effect of household contact management on childhood tuberculosis: a mathematical modelling study

Dodd

Yuen

Becerra

et al. 2018

The Lancet Global Health

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SummaryBackgroundTuberculosis is recognised as a major cause of morbidity and mortality in children, with most cases in children going undiagnosed and resulting in poor outcomes. Household contact management, which aims to identify children with active tuberculosis and to provide preventive therapy for those with HIV or those younger than 5 years, has long been recommended but has very poor coverage globally. New guidelines include widespread provision of preventive therapy to children with a positive tuberculin skin test (TST) who are older than 5 years.MethodsIn this mathematical modelling study, we provide the first global and national estimates of the impact of moving from zero to full coverage of household contact management (with and without preventive therapy for TST-positive children older than 5 years). We assembled data on tuberculosis notifications, household structure, household contact co-prevalence of tuberculosis disease and infection, the efficacy of preventive therapy, and the natural history of childhood tuberculosis. We used a model to estimate households visited, children screened, and treatment courses given for active and latent tuberculosis. We calculated the numbers of tuberculosis cases, deaths, and life-years lost because of tuberculosis for each intervention scenario and country.FindingsWe estimated that full implementation of household contact management would prevent 159 500 (75% uncertainty interval [UI] 147 000–170 900) cases of tuberculosis and 108 400 (75% UI 98 800–116 700) deaths in children younger than 15 years (representing the loss of 7 305 000 [75% UI 6 663 000–7 874 000] life-years). We estimated that preventing one child death from tuberculosis would require visiting 48 households, screening 77 children, giving 48 preventive therapy courses, and giving two tuberculosis treatments versus no household contact management.InterpretationHousehold contact management could substantially reduce childhood disease and death caused by tuberculosis globally. Funding and research to optimise its implementation should be prioritised.FundingUK Medical Research Council, US National Institutes of Health, Fulbright Commission, Janssen Global Public Health.

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“…Finally, we estimated the relative diagnostic costs and cost per Bac(+) TB case incurred by the health system for each of the aforementioned screening and diagnostic algorithms. Diagnostic costs were obtained from a Vietnamese health systems costing study [25], including USD 0.18 per AFB smear microscopy test performed and USD 11.12 per Xpert test performed (USD 0.83 for consumables, USD 9.98 for the Xpert cartridge [26] and USD 0.31 for shipping (obtained from the study's Cepheid shipping documents)). The cost of a provincial-level laboratory technician (USD 216 per month) was also included for the full 19-month project duration.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…The cost per Bac(+) case was calculated by dividing the total diagnostic testing costs by each algorithm's estimated yield. We did not differentiate between the detection of drug-sensitive and -resistant TB; the incremental costs for confirming a drug-resistant TB diagnosis have been reported elsewhere [25].…”

Section: Statistical Analysesmentioning

confidence: 99%

An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam

Nguyen

Codlin²,

Vo³

et al. 2020

TropicalMed

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Across Asia, a large proportion of people with tuberculosis (TB) do not report symptoms, have mild symptoms or only experience symptoms for a short duration. These individuals may not seek care at health facilities or may be missed by symptom screening, resulting in sustained TB transmission in the community. We evaluated the yields of TB from 114 days of community-based, mobile chest X-ray (CXR) screening. The yields at each step of the TB screening cascade were tabulated and we compared cohorts of participants who reported having a prolonged cough and those reporting no cough or one of short duration. We estimated the marginal yields of TB using different diagnostic algorithms and calculated the relative diagnostic costs and cost per case for each algorithm. A total of 34,529 participants were screened by CXR, detecting 256 people with Xpert-positive TB. Only 50% of those diagnosed with TB were detected among participants reporting a prolonged cough. The study’s screening algorithm detected almost 4 times as much TB as the National TB Program’s standard diagnostic algorithm. Community-based, mobile chest X-ray screening can be a high yielding strategy which is able to identify people with TB who would likely otherwise have been missed by existing health services.

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Costs of providing tuberculosis diagnosis and treatment services in Viet Nam

Abstract: The cost of TB diagnosis and treatment services in Viet Nam varied according to level of health facility, type of TB, different costing options, and different staff cost scenarios.

Cited by 7 publications

References 0 publications

Association between economic development level and tuberculosis registered incidence in Shandong, China

Association between economic development level and tuberculosis registered incidence in Shandong, China

Potential effect of household contact management on childhood tuberculosis: a mathematical modelling study

An Evaluation of Programmatic Community-Based Chest X-ray Screening for Tuberculosis in Ho Chi Minh City, Vietnam

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