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Economic Evaluation of the Initiative Control of Tuberculosis in Large Metropolitan Cities in Lima, Peru
UNIFORMED SERVICES UNIV OF THE HEALTH SCIENCES BETHESDA MD BETHESDA United States
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Tuberculosis TB is still a major public health concern worldwide and, according to the World Health Organization WHO, in 2013 there were an estimated 9 million new cases of TB. On the other hand, it is widely recognized that the burden of TB is often greater in urban than rural settings, both in developing and industrialized countries. This fact is certainly true in Latin America and the Caribbean LAC and in Peru too. Lima - the capital of Peru - has twenty-five percent of the countrys urban poor, and reports 60 of the tuberculosis cases for the entire country, as well as 85 of drug resistant tuberculosis cases. In response to this scenario, PAHO has designed the Control of Tuberculosis in large metropolitan cities in LAC initiative, with the goal of reducing the impact of the TB epidemic through a comprehensive intervention that cover all the main barriers of the TB control in large cities. Peru has implemented this focalized intervention to reduce one of the main problems of TB control in Lima, which is treatment default affecting both the successful treatment and the transmission of TB in the community. The focalized intervention is based on daily monitoring of the patient treatment, 100 compliance with a baseline comprehensive assessment, and home visits and counseling if the patients missed one day of treatment. This study had three objectives. First, to determine the incremental effectiveness of the focalized intervention compared to the existing program to determine the cost-effectiveness and cost-utility of the focalized intervention compared to the existing program and to determine the cost-benefits of the focalized intervention compared to the existing program. We used a provider perspective.
APPROVED FOR PUBLIC RELEASE