University of Alabama at Birmingham (UAB) researchers have found that the cost of preventive antibiotic tuberculosis (TB) therapy for patients infected by human immunodeficiency virus (HIV) is generally less expensive than the reported cost of treating newly confirmed TB cases.

The study, published in The International Journal of Tuberculosis and Lung Disease this summer, relied on treatment-cost estimates from previous research studies and data collected by members of the study’s research team at a TB treatment site in Cambodia.

“We completed this study to provide health-program managers cost and cost-effectiveness data on components of a comprehensive package of HIV care. This data is essential to help establish feasible and effective ways to manage patients with human immunodeficiency virus infection and tuberculosis in a developing country,” said Bryce Sutton, Ph.D., an economist in the UAB School of Business and one of the study’s co-investigators.

The research found that the cost of preventing a single case of TB with intensive screening and preventive treatment with antibiotics in HIV-infected patients prior to their exposure to the disease was approximately $950. Compare that to a cost range of $900-$1500, which is the previously reported range for treating a new smear-positive TB case in a developing country setting after adjusting for inflation.

“Our analysis showed that the costs associated with screening and preventive treatment for TB among HIV-infected patients was comparable to the cost related to treating a patient with a newly confirmed case of TB,” Sutton said. “When you factor in observed high adherence rate to treatment and other cost savings such as averted productivity losses that come with stopping TB’s spread through the preventive care, we believe that this type of integrated care offers a potential savings to governments and health-care agencies.”

Sutton said preventing the spread of TB goes beyond cost-savings and can positively affect local, regional and national developing economies.

“Diseases like tuberculosis in a developing country setting can be catastrophic both in terms of health and the financial burden it places on families,” he said. “Often other family members stop working to become caretakers; children and young adults may be forced to enter the workforce to pay for expenses and forgo receiving an education, which can start a cycle of poverty.

“These are important economic factors that support the adoption of preventive-care TB policies.”

Former UAB Professor of Infectious Diseases Michael Kimerling, M.D., is the study’s co-investigator. Former UAB graduate researchers Phalkun Chheng and Mayra Arias and M.T. Eang from the National Tuberculosis and Leprosy Control (CENAT) Phnom Penh, Cambodia, also are on the research team.

Data used in the study were collected at one of four pilot treatment sites facilitated in Cambodia through the UAB-led Gorgas Tuberculosis Initiative, which was created to establish feasible and effective ways to manage patients with HIV and TB.

Source:
Andrew Hayenga

University of Alabama at Birmingham

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The WHO has warned that people with conditions such as HIV, tuberculosis and malaria should not rely on homeopathic treatments, the BBC reports. The agency was responding to a June letter (full text available here), in which researchers from the Voice of Young Science Network called on the agency “to condemn the promotion of homeopathy for treating TB, infant diarrhoea, influenza, malaria and HIV.” The group, which is part of the Sense About Science organization that advocates for “evidence-based” care, has conveyed the WHO’s views in a letter to health ministers, according to the BBC (8/20).

According to a Sense About Science release, the organizations received comments from five WHO officials, which “clearly express WHO’s position” (8/21). Mario Raviglione, director of the Stop TB department at the WHO, said, “Our evidence-based WHO TB treatment/management guidelines, as well as the International Standards of Tuberculosis Care do not recommend use of homeopathy.” In addition, a spokesman for the WHO department of child and adolescent health and development said of treating diarrhea in children: “We have found no evidence to date that homeopathy would bring any benefit,” the BBC writes (8/20). The release includes additional comments from the associate director of WHO’s global malaria program, the HIV/AIDS department interim director and others (8/21).

Robert Hagan, a researcher in biomolecular science at the University of St. Andrews and a member of Voice of Young Science Network, said, “We need governments around the world to recognise the dangers of promoting homeopathy for life-threatening illnesses. We hope that by raising awareness of the WHO’s position on homeopathy we will be supporting those people who are taking a stand against these potentially disastrous practices,” BBC writes (8/20).

This information was reprinted from globalhealth.kff.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Global Health Policy Report, search the archives and sign up for email delivery at globalhealth.kff.org.

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