Community-based DOTS and family member DOTS for TB control in Nepal: costs and cost-effectiveness
2008

Cost-Effectiveness of TB Control Strategies in Nepal

Sample size: 50 publication Evidence: moderate

Author Information

Author(s): Tolib Mirzoev, Sushil Baral, Deepak Karki, Andrew Green, James Newell

Primary Institution: Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, UK

Hypothesis

What are the costs and cost-effectiveness of community-based and family-based DOTS strategies for TB control in Nepal?

Conclusion

The community-based DOTS strategy is more cost-effective than the family-based DOTS strategy in the context of the study districts in Nepal.

Supporting Evidence

  • The total recurrent costs per patient were US$76.2 for the CBD strategy and US$84.1 for the FBD strategy.
  • Social costs represented more than a third of total recurrent costs under both strategies.
  • The treatment success rates were 85% for CBD and 89% for FBD, with no significant difference between the two.

Takeaway

This study looked at two ways to help people with tuberculosis get treatment in Nepal. It found that having community workers help patients is cheaper and works better than having family members help.

Methodology

Costs were collected using structured and semi-structured questionnaires from health facility records and a sample of 10 patients in each of 10 districts.

Limitations

The estimates of cost-effectiveness were sensitive to small changes in underlying costs and treatment outcomes.

Participant Demographics

Patients included in the study were from 10 districts in Nepal, with varying access to health facilities.

Digital Object Identifier (DOI)

10.1186/1478-7547-6-20

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