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

1.	萬康林. 中國結核病流行新特點及挑戰. 疾控監測, 2008, 23(11):667-670.
2.	衛生部疾病預防控制局. 中國結核病防治規劃實施工作指南(2008年版). 北京:中國協和醫科大學出版社, 2009.
3.	全國第五次結核病流行病學抽樣調查技術指導組/全國第五次結核病流行病學抽樣調查辦公室. 2010年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 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.	李建偉, 鐘球, 黃桂清, 等. 不同人群篩查肺結核病人的效果評價. 中國防癆雜志, 2004, 26(3):136-138.
6.	王宏. 結核病防治DOTS方案的經濟學評價. 中國衛生經濟雜志, 2009, 28(4):27-28.
7.	許群. 初治涂陽肺結核病人DOTS和非DOTS干預的成本-效果分析. 中國防癆雜志, 2000, 22(2):60-62.
8.	王蕓, 許琳, 邱玉冰, 等. 主動篩查方式下云南省6個偏遠農村肺結核患病情況分析. 現代預防醫學, 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.	姜偉, 黃莉芳. 全民健康普查在肺結核主動發現中的作用研究. 現代預防醫學, 2012, 39(12):3102-3103, 3105.
16.	中華人民共和國衛生部. WS288-2008肺結核診斷標準. 北京:人民衛生出版社, 2008.
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18.	許群, 烏正賚, 金水高, 等. 初治涂陽肺結核病人及其傳染性所致疾病負擔的評價方法研究. 衛生研究, 2003, 32 (6):558-561.
19.	馬艷, 成詩明, 周林. 涂陰肺結核診斷和治療進展. 中國健康教育, 2008, 24 (6):451-455.
20.	王隴德. 結核病防治. 第1版. 北京:中國協和醫科大學出版社, 2004.
21.	衛生統計信息中心. 中國衛生服務調查研究第三次國家衛生服務調查分析報告. 北京:中國協和醫科大學出版社, 2004.
22.	龔幼龍, 萬利亞, 武桂英. 結核病控制經濟與管理學評價. 第1版. 上海:第二軍醫大學出版社, 2003:373-374.
23.	李嵐, 盧和平. 結核患者用藥依從性及影響因素調查. 臨床醫藥實踐, 2010, 19(4):506-507.
24.	唐琴, 馮艷萍, 馮先惠. 門診健康教育對結核患者治療依從性的影響. 2013, 10(14):1898-1899.
25.	沈建恩, 雷濤, 王祖恩. 肺結核病人化療依從性相關因素研究. 中國防癆雜志, 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. 萬康林. 中國結核病流行新特點及挑戰. 疾控監測, 2008, 23(11):667-670.
2. 衛生部疾病預防控制局. 中國結核病防治規劃實施工作指南(2008年版). 北京:中國協和醫科大學出版社, 2009.
3. 全國第五次結核病流行病學抽樣調查技術指導組/全國第五次結核病流行病學抽樣調查辦公室. 2010年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 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. 李建偉, 鐘球, 黃桂清, 等. 不同人群篩查肺結核病人的效果評價. 中國防癆雜志, 2004, 26(3):136-138.
6. 王宏. 結核病防治DOTS方案的經濟學評價. 中國衛生經濟雜志, 2009, 28(4):27-28.
7. 許群. 初治涂陽肺結核病人DOTS和非DOTS干預的成本-效果分析. 中國防癆雜志, 2000, 22(2):60-62.
8. 王蕓, 許琳, 邱玉冰, 等. 主動篩查方式下云南省6個偏遠農村肺結核患病情況分析. 現代預防醫學, 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. 姜偉, 黃莉芳. 全民健康普查在肺結核主動發現中的作用研究. 現代預防醫學, 2012, 39(12):3102-3103, 3105.
16. 中華人民共和國衛生部. WS288-2008肺結核診斷標準. 北京:人民衛生出版社, 2008.
17. 衛生部辦公廳. 關于開展《全國結核病防治規劃(2001-2010年)》終期評估的通知. Available at:http://www.moh.gov.cn/jkj/s3589/201009/946689dd09924a509b0c6f9f86169548.shtml.
18. 許群, 烏正賚, 金水高, 等. 初治涂陽肺結核病人及其傳染性所致疾病負擔的評價方法研究. 衛生研究, 2003, 32 (6):558-561.
19. 馬艷, 成詩明, 周林. 涂陰肺結核診斷和治療進展. 中國健康教育, 2008, 24 (6):451-455.
20. 王隴德. 結核病防治. 第1版. 北京:中國協和醫科大學出版社, 2004.
21. 衛生統計信息中心. 中國衛生服務調查研究第三次國家衛生服務調查分析報告. 北京:中國協和醫科大學出版社, 2004.
22. 龔幼龍, 萬利亞, 武桂英. 結核病控制經濟與管理學評價. 第1版. 上海:第二軍醫大學出版社, 2003:373-374.
23. 李嵐, 盧和平. 結核患者用藥依從性及影響因素調查. 臨床醫藥實踐, 2010, 19(4):506-507.
24. 唐琴, 馮艷萍, 馮先惠. 門診健康教育對結核患者治療依從性的影響. 2013, 10(14):1898-1899.
25. 沈建恩, 雷濤, 王祖恩. 肺結核病人化療依從性相關因素研究. 中國防癆雜志, 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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