BMC Public Health (Jan 2019)

Comparison of clinical and cost-effectiveness of two strategies using mobile digital x-ray to detect pulmonary tuberculosis in rural India

  • Bornali Datta,
  • Ashish Kumar Prakash,
  • David Ford,
  • Praveen K. Tanwar,
  • Pinky Goyal,
  • Poulomi Chatterjee,
  • Smita Vipin,
  • Anand Jaiswal,
  • Naresh Trehan,
  • Kavita Ayyagiri

DOI
https://doi.org/10.1186/s12889-019-6421-1
Journal volume & issue
Vol. 19, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Background Medanta - The Medicity, a multi-super specialty corporate hospital in Gurugram, Haryana launched a “TB-Free Haryana” Campaign; mobile van equipped with a digital CXR machine to screen patients with presumptive Tuberculosis (TB). Objectives: In this study, we aimed to assess the (1) yield and cost analysis of two strategies using mobile digital x-ray to detect Pulmonary TB in rural Haryana. Methods An observational study was conducted on all individuals screened by either of the two case finding strategies using a mobile x-ray unit (MXU) mounted on a mobile van in District Mewat, Haryana during Jan-March 2016. Results Strategy 1: Out of 121 smear negative cases, x-rays were suggestive of TB in 39(32%), of which 24 were started on TB treatment. Cost of identifying a smear negative TB was US$ 32. Strategy 2: Out of 596 presumptive TB, chest x-rays were suggestive of TB in 108 (18%), of which 67 were started on TB treatment (56 were smear negative TB). Cost of detecting any case of TB was US$ 08 (1 USD = 64 INR). Conclusion The study reports a new initiative within a PPM model to improve the diagnosis of PTB by filling the gap in the current diagnostic infrastructure. We believe there is potential for replication of strategy 2 model in other states, although further evidence is required.

Keywords