Cost-effectiveness and budget impact of decentralising childhood TB diagnosis
d'Elbée, M., Harker, M., Mafirakureva, N., Nanfuka, M., Nguyet, M.H.T.N., Taguebue, J.V., Moh, R., Khosa, C., Mustapha, A., Mwanga-Amumpere, J. and Borand, L., 2024. Cost-effectiveness and budget impact of decentralising childhood tuberculosis diagnosis in six high tuberculosis incidence countries: a mathematical modelling study. EClinicalMedicine , 70 , p.102528. Diagnosing tuberculosis (TB) in children is challenging due to difficulties in collecting sputum samples and the paucibacillary nature of pulmonary TB in children. Alternative specimen collection methods like induced sputum and gastric aspirate require specialized equipment and trained personnel, which are often unavailable at primary health centers (PHC) and sometimes even at district hospitals (DH). As a result, many children with symptoms suggestive of TB do not receive appropriate diagnostic tests, even at the DH level. Stool samples can be collected more easily in young children across various settings and can be u