Cost-Effectiveness of Integrating Pediatric Tuberculosis Services in Africa
Background
In 2021, over one million children got tuberculosis (TB), leading to 214,000 deaths. This is mainly due to poor diagnosis and treatment. Most high-burden countries have centralized TB services, making it hard to access care. To improve TB detection and treatment in children, the World Health Organization (WHO) suggests integrating TB services into child healthcare. The INPUT trial studied this integration in Cameroon and Kenya, showing a significant increase in TB detection in Cameroon but not in Kenya.
Methods
We assessed the impact of the intervention on healthcare outcomes, resource use, and costs using a decision tree model based on INPUT trial data. We looked at health outcomes related to TB treatment, focusing on mortality and disability-adjusted life-years (DALYs).
Findings
– For every 100 children treated under standard care, an additional 876 in Cameroon and 6 in Kenya would receive treatment through the intervention.
– Treatment success would rise by 5% in Cameroon and 9% in Kenya with the intervention.
– An estimated 350 deaths would be prevented in Cameroon, while only 3 in Kenya.
– The cost-effectiveness ratio was US$506 per DALY averted in Cameroon and US$1299 in Kenya.
Interpretation
Integrating TB services into child healthcare can be effective, but its cost-effectiveness relies on the existing healthcare coverage and TB treatment outcomes.
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