Slide 155 Interventions for Tuberculosis Control and Elimination
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All HIV-infected patients in Switzerland are enrolled in a large cohort study. One of teh components of care that is offered and evaluated is preventive therapy. The criterion for providing preventive therapy is a tuberculin skin test result with an induration of 5 or more millimeters. Among those patients who met the inclusion criterion and actually received preventive therapy, no case of tuberculosis emerged, while among those approximately 2,000 patients who were not tested, 30 cases developed. Importantly, among the over 4,000 who did not meet the inclusion criterion, there were also 10 cases and among those who met the inclusion criterion, but who did not receive preventive therapy for one or another reason, there were an additional 10 cases. The authors of the study concluded that the intervention was efficacious. This is correct, there were no cases among those receiving preventive therapy and it can be calculated the 9.6 cases were averted by the intervention. Perhaps programmatically more important, however, is that the intervention was neither effective (only 9.7 cases were averted, but 56 did occur) nor was it efficient, because the cost of testing and evaluating 4,500 cases must have been substantial.
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Last update: September 29, 2010