The Economic Impact of Case Finding for Infectious Disease in a Global Health Context

Abstract

Despite advances in recent years, human immunodeficiency virus (HIV) and tuberculosis (TB) are major contributors to global morbidity and mortality. Progress in mitigating the spread and impact of both infectious diseases is being made in many settings, but there is an ongoing gap in hard- to-reach and marginalized populations. Early diagnosis and treatment of infectious diseases is a core component of global efforts to mitigate infectious disease burden. The cost effectiveness of enhanced screening through systematic screening and self-testing (ST) is imperative prior to scaling up these programs given the reality of finite resources within any health care setting. We have undertaken a systematic review to summarize the current economic literature around systematic screening for active TB and ST for HIV. The inputs from the HIVST systematic review were used to create a combined decision tree and Markov model to evaluate the cost utility of HIVST along with digital and community-based programs to support downstream linkage to care.