School-Based Screening for Tuberculous Infection: A Cost-Benefit Analysis

摘要: Objective. —To compare tuberculin screening of all kindergartners and high school entrants (screen-all strategy) vs limited to high-risk children (targeted screening). Design. —Decision, cost-effectiveness, cost-benefit analyses. Setting Subjects. —Students in a large urban rural county. Definitions. —High risk tuberculous infection was defined as birth country with prevalence tuberculosis. Low the United States. Outcome Measures. —Tuberculosis cases prevented per 10000 screened. Net costs, net cost case prevented, benefit-cost ratio, incremental cost-effectiveness. Results. —The screen-all strategy would prevent 14.9 10 000 screened; targeted 84.9 The is more costly than no screening; ratio 0.58. Targeted result savings; 1.2. Screening saving only if reactor rate 20% or greater. additional for compared ($34 666) twice treatment contact tracing tuberculosis ($16392). Conclusions. —Targeted schoolchildren much less mass efficient prevention (JAMA. 1995;274:613-619)