Cost Benefit of Contact-Tracing in a Tuberculosis Programme

Abstract

Summary :  In order to assess the cost-benefit of contact examination in a tuberculosis programme, we analysed the results of examinations carried out on household contacts of cases of tuberculosis treated at the University of Benin Teaching Hospital (UBTH) during a two-year period. There were eight children with active disease among 332 persons, aged less than 15 years, found in households of 66 cases of tuberculosis containing 509 members. These constituted 7.8% of 103 children under 15 years old treated for iuberculosis in the hospital during the period. The estimated time spent by public health nurses to carry out contact-tracing was 396 bours valued at N!,061.28 and the distance travelled was 6,552 km at a cost of N655.20. Thus, an extra sum of N1,716.48 was spent by the hospital to detect 7.8% of children treated for tuberculosis. It is suggested that in a country with limited resources, the extra sum of moncy spent to find less than 10% of the children treated for tuberculosis could be more judiciously used for case detection in out-patient clinics. Alternatively, additional services such as administration of INH to children under 4 years of age with positive tuberculin test should be done during home visits in order to increase cost effectiveness of contact.