A cost-effectiveness analysis of the tuberculosis control procedures applied in the Cape Divisional Council area

Master Thesis


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University of Cape Town

This study evaluates the costs and effectiveness of preventive and curative procedures currently available for Tuberculosis (TB) control purposes. The procedures examined are as follows : i) BCG vaccinations; ii) Secondary chemoprophylaxis; iii) Health education; iv) Mass screening campaigns; v) Investigation of contacts of infectious TB cases and symptomatic persons, i.e. suspects; and vi) Treatment regimens for notified TB patients. The analysis is largely based on data from the records of 300 randomly selected TB patients, treated at clinics in the Cape Divisional Council area in 1983. The major finding of this study is that resources available for TB control should be reallocated in the direction of secondary chemoprophylaxis, BCG vaccination administration in the Black and Coloured populations, investigation of contacts and suspects, and ambulatory treatment of notified TB patients. Conversely, vaccinating the White population, mass screening campaigns and hospitalisation of TB patients should be given relatively less emphasis in the overall TB control programme. In addition, the proportion of patients confirmed as TB cases by means of bacteriological examinations should be increased to reduce misdiagnosis.

Bibliography: leaves 215-226.