Geospatial clustering and modelling provide policy guidance to distribute funding for active TB case finding in Ethiopia

• DOI: 10.1016/j.epidem.2021.100470
• Publication Date: 2021-05-19T16:35:50Z
• Authors: Debebe Shaweno; James M. Trauer; Tan N. Doan; Justin T. Denholm; Emma S. McBryde
• Keywords: Hotspot (geology); Case finding

Tuberculosis (TB) exhibits considerable spatial heterogeneity, occurring in clusters that may act as hubs of community transmission. We evaluated the impact an intervention targeting TB hotspots a rural region Ethiopia. To evaluate targeted active case finding (ACF), we used spatially structured mathematical model has previously been described. From equilibrium, simulated hotspot-targeted strategy (HTS) on incidence ten years from commencement and associated cost-effectiveness. HTS was also compared with untargeted (UTS). logistic cost-coverage analysis to estimate cost-effectiveness interventions. At screening coverage level 95 % hotspot region, which corresponds 20 total population, would reduce overall by 52 baseline. For UTS achieve equivalent effect, it be necessary screen more than 80 population. Compared existing passive detection strategy, at CDR 75 percent regions is expected avert 1,023 new cases over saving USD 170 per averted case. Similarly, same CDR, will detect 1316 period 3 The incremental-cost effectiveness-ratio (ICER) 582 corresponding 293 additional cost 170,700. Where regional program spending capped current levels, maximum gains reduction were seen when budget shared between non-hotspot ratio 40% : 60%. Our suggests efficient cost-saving, potential for significant burden.