文章基本信息

标题：A systematic review of economic evaluations of interventions to tackle tuberculosis in homeless people
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作者：Silva, Everton Nunes ; Pereira, Ana Carolina Esteves da Silva ; Araújo, Wildo Navegantes de 等
期刊名称：Revista Panamericana de Salud Pública
印刷版ISSN：1020-4989
出版年度：2018
卷号：42
页码：e40
DOI：10.26633/rpsp.2018.40
语种：English
出版社：Organización Panamericana de la Salud
摘要：Objective To analyze economic evaluations of interventions related to tuberculosis (TB) diagnostics/screening, treatment, and prevention in homeless people. Methods A systematic review was conducted. The eligibility criteria were original studies reporting economic evaluation results. The search was not restricted by language or year. A critical appraisal approach was used. Results A total of 142 studies were identified, including five research articles (three full economic evaluations and two partial) that were selected for the final review. Most of the studies were conducted in the United States, adopted a public health perspective, and analyzed active TB. Interventions related to diagnostics/screening (the use of interferon-gamma release assay (IGRA) and mobile screening units), treatment (incentives for continuing treatment, and housing programs), and prevention (with the Bacillus Calmette–Guérin (BCG) vaccine) were identified. Conclusions No high-quality data were found on cost-effectiveness of interventions on TB diagnostics/screening, treatment, or prevention in homeless people. However, active searching for cases via mobile screening, and financial incentives, could help increase treatment adherence, and the use of IGRA helps boost detection. TB in homeless people is neglected worldwide, especially in developing countries, where this disease tends to afflict more people made vulnerable by their precarious living conditions. Public funding mechanisms should be created to develop cross-sectoral actions targeting homeless people, as the complex dynamics of this group tend to hamper prevention and diagnosis of TB and the completion of TB treatment.
关键词：Homeless persons;tuberculosis;cost-benefit analysis;review