| Tuberculosis prevention in methadone maintenance clinics. Effectiveness and cost-effectiveness. | |
| | |
MedLine Citation:
|
PMID: 10390397 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
To determine the effectiveness and cost-effectiveness of a program to provide screening for tuberculosis infection and directly observed preventive therapy (DOPT) in methadone maintenance clinics, we determined completion rates of screening for tuberculosis infection, medical evaluation, and preventive therapy, as well as the number of active tuberculosis cases and tuberculosis-related deaths prevented, in five clinics in San Francisco, California. Between 1990 and 1995, a total of 2,689 clients (of whom 18% were HIV-seropositive) were screened at least once. Of eligible clients, 99% received tuberculin skin tests, 96% received a medical examination, 91% began isoniazid preventive therapy, and 82% completed preventive therapy. Program effectiveness was enhanced by close collaboration between public health and methadone maintenance programs and the use of incentives and enablers. Over a 3-yr follow-up period, only one verified case of tuberculosis was reported among clients with a positive tuberculin skin test, thereby preventing as much as 95% of expected tuberculosis cases. Over 10 yr, we estimate the program would prevent 30.0 (52%) of 57.7 expected cases of tuberculosis, and 7.6 (57%) of 13.4 expected tuberculosis-related deaths. The program cost $771,569, but averted an estimated $876,229, for a net savings of $104,660 (average of $3, 724 per case prevented). Our study demonstrates that when effectively implemented, screening for tuberculosis infection and DOPT in methadone maintenance clinics is a highly cost-effective approach to prevent tuberculosis. |
| | |
Authors:
|
D C Snyder; E A Paz; J C Mohle-Boetani; R Fallstad; R L Black; D P Chin |
Related Documents
:
|
6826147 - Training personnel in the prevention and management of violent behavior. 12611417 - Characteristics of effective school-based substance abuse prevention. 18821367 - Effects of being a peer-leader in an eating disorder prevention program: can we further... 11960187 - Semiquantitative mercury determination in fish: a tool for poisoning prevention. 22482377 - Medical students' perspective about role-plays as a teaching strategy in community medi... 18082537 - Patient assessment and management examination: lack of correlation between faculty asse... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: American journal of respiratory and critical care medicine Volume: 160 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 1999 Jul |
Date Detail:
|
Created Date: 1999-08-11 Completed Date: 1999-08-11 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 178-85 Citation Subset: AIM; IM; X |
Affiliation:
|
California Department of Health Services, Tuberculosis Control Branch, Francis J. Curray National Tuberculois Center, San Francisco, CA, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
AIDS-Related Opportunistic Infections
/
economics,
mortality,
prevention & control* Adult Antitubercular Agents / administration & dosage Cost-Benefit Analysis Drug Therapy, Combination Female Follow-Up Studies HIV Seropositivity / diagnosis*, economics, mortality Humans Isoniazid / administration & dosage Male Mass Screening / economics* Methadone / economics, therapeutic use* Middle Aged Pyridoxine / administration & dosage San Francisco Substance Abuse, Intravenous / economics, mortality, rehabilitation* Survival Rate Treatment Outcome Tuberculin Test / economics Tuberculosis, Pulmonary / economics, mortality, prevention & control* Urban Population* / statistics & numerical data |
| Chemical | |
Reg. No./Substance:
|
0/Antitubercular Agents; 54-85-3/Isoniazid; 65-23-6/Pyridoxine; 76-99-3/Methadone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Progressive mechanical ventilatory constraints with aging.
Next Document: Quantitation of inflammatory responses to bacteria in young cystic fibrosis and control patients.