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Free Content The cost of intensified case finding and isoniazid preventive therapy for HIV-infected patients in Battambang, Cambodia

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Abstract:

SETTING: The current study evaluates one of four pilot sites initiated in Cambodia to establish feasible and effective ways to manage patients with human immunodeficiency virus (HIV) infection and tuberculosis (TB).

OBJECTIVE: To measure the costs of intensified case finding (ICF) and isoniazid preventive therapy (IPT) services for HIV-infected patients in Battambang Province, Cambodia.

DESIGN: We analyzed cost data retrospectively from September 2003 to February 2006 using a microcosting or ingredients-based approach and interviewed clinic personnel to determine the cost of ICF and IPT per person.

RESULTS: Adherence to IPT at Battambang IPT clinic was high (86%) relative to other reported studies of IPT among HIV patients in developing countries. The estimated cost per TB case averted through ICF was US$363, while the estimated cost per TB case averted through IPT was US$955.

CONCLUSION: Economic evaluations of TB-HIV integrated services are necessary as countries move to establish or scale-up these services. Based upon the estimated effectiveness of ICF and IPT used by other studies examining the provision of integrated HIV-TB services, the cost per TB case prevented by ICF and IPT in Battambang, Cambodia, is less than the reported cost of treating a new smear-positive TB case.

Keywords: cost-effectiveness; human immunodeficiency virus; intensified case finding; isoniazid preventive therapy; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Finance, Economics and Quantitative Methods, University of Alabama at Birmingham, Birmingham, Alabama, USA 2: Division of Infectious Diseases, Gorgas Tuberculosis Initiative, University of Alabama at Birmingham, Birmingham, Alabama, USA 3: National Center for Tuberculosis and Leprosy Control (CENAT) Phnom Penh, Cambodia 4: Division of Infectious Diseases, Gorgas Tuberculosis Initiative, University of Alabama at Birmingham, Birmingham, Alabama, USA; and Bill and Melinda Gates Foundation, Seattle, Washington, USA

Publication date: June 1, 2009

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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