Projecting the impact and costs of near point-of-care tuberculosis screening assays in community-based active case finding
Community-based active case finding (ACF) may reduce tuberculosis incidence and mortality but is not widely implemented due to resource constraints. How novel screening test characteristics would affect the impact and costs of ACF strategies is not clear.We developed mathematical models of tuberculo...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
15 October 2025
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| In: |
Clinical infectious diseases
Year: 2025, Volume: 81, Issue: 4, Pages: 776-784 |
| ISSN: | 1537-6591 |
| DOI: | 10.1093/cid/ciaf395 |
| Online Access: | Resolving-System, lizenzpflichtig, Volltext: https://doi.org/10.1093/cid/ciaf395
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| Author Notes: | Jason R. Andrews, Emily A. Kendall, Adithya Cattamanchi, Claudia M. Denkinger, Payam Nahid, Sourya Shrestha, Florian M. Marx, David Dowdy, Sabine Hermans, and Frank Cobelens |
| Summary: | Community-based active case finding (ACF) may reduce tuberculosis incidence and mortality but is not widely implemented due to resource constraints. How novel screening test characteristics would affect the impact and costs of ACF strategies is not clear.We developed mathematical models of tuberculosis natural history and transmission, calibrated to data from 3 high tuberculosis burden countries (India, Vietnam, and the Philippines) and simulated the impact of annual community-based ACF programs. We compared annual screening, with or without an initial symptom screen, for 10 years with 2 hypothetical screening assays based on target product profile minimum targets: a low complexity (reaches 60% of the population) test with high sensitivity (90%) and moderate specificity (80%) costing USD 3; and a near point-of-care (reaches 80% of the population) test with moderate sensitivity (55%) and high specificity (98%) costing USD 2. We projected reductions in tuberculosis incidence, mortality, and costs under each scenario.Annual screening with a low-complexity, high-sensitivity screening assay was projected to reduce tuberculosis mortality by 24%-38%, at an annual cost of USD 5.04-USD 5.83 per capita. Annual screening with a near-point-of-care, moderate-sensitivity assay was projected to achieve comparable reductions in mortality (24%-42%) at USD 3.49-USD 3.63 per capita. Symptom-based screening would yield more modest reductions in tuberculosis mortality (17%-24%) at an annual cost of around USD 1 per capita.Near point-of-care, moderate-sensitivity screening assays for tuberculosis could achieve substantial impact on tuberculosis mortality—equivalent to that of high-sensitivity assays and at lower cost—if they can be performed at scale in community settings. |
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| Item Description: | Online veröffentlicht am: 17. Juli 2025 Gesehen am 09.04.2026 |
| Physical Description: | Online Resource |
| ISSN: | 1537-6591 |
| DOI: | 10.1093/cid/ciaf395 |