screening and rapid molecular diagnosis of tuberculosis in prisons in russia and eastern europe a cost-effectiveness analysis筛查和快速分子诊断肺结核的监狱在俄罗斯和东欧一个成本效益分析.pdfVIP
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screening and rapid molecular diagnosis of tuberculosis in prisons in russia and eastern europe a cost-effectiveness analysis筛查和快速分子诊断肺结核的监狱在俄罗斯和东欧一个成本效益分析
Screening and Rapid Molecular Diagnosis of Tuberculosis
in Prisons in Russia and Eastern Europe: A Cost-
Effectiveness Analysis
1 2 1 3
Daniel E. Winetsky , Diana M. Negoescu , Emilia H. DeMarchis , Olga Almukhamedova ,
3 3 3 4,5
Aizhan Dooronbekova , Dilshod Pulatov , Natalia Vezhnina , Douglas K. Owens , Jeremy D. Goldhaber-
Fiebert5*
1 Stanford University School of Medicine, Stanford, California, United States of America, 2 Department of Management Science and Engineering, Stanford University,
Stanford, California, United States of America, 3 AIDS Foundation East-West, Amsterdam, The Netherlands, 4 Veterans Affairs Palo Alto Health Care System, Palo Alto,
California, United States of America, 5 Center for Health Policy/Center for Primary Care and Outcomes Research, Stanford University, Stanford, California, United States of
America
Abstract
Background: Prisons of the former Soviet Union (FSU) have high rates of multidrug-resistant tuberculosis (MDR-TB) and are
thought to drive general population tuberculosis (TB) epidemics. Effective prison case detection, though employing more
expensive technologies, may reduce long-term treatment costs and slow MDR-TB transmission.
Methods and Findings: We developed a dynamic transmission model of TB and drug resistance matched to the
epidemiology and costs in FSU prisons. We evaluated eight strategies for TB screening and diagnosis involving, alone or in
combination, self-referral, symptom screening, mass miniature radiography (MMR), and sputum PCR with probes for
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