Personal and societal health quality lost to tuberculosis.

<h4>Background</h4>In developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in...

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Autores principales:	Thaddeus L Miller, Scott J N McNabb, Peter Hilsenrath, Jotam Pasipanodya, Stephen E Weis
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/f900324dd1ab44a69c4f674d64a9bf64
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spelling	oai:doaj.org-article:f900324dd1ab44a69c4f674d64a9bf642021-11-25T06:16:16ZPersonal and societal health quality lost to tuberculosis.1932-620310.1371/journal.pone.0005080https://doaj.org/article/f900324dd1ab44a69c4f674d64a9bf642009-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19352424/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>In developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in a majority of patients who have completed treatment for pulmonary tuberculosis (PTB). This and other health effects of tuberculosis have not been considered in QALY calculations. Consequently both the burden of tuberculosis on the individual and the value of tuberculosis prevention to society are underestimated. We estimated QALYs lost to pulmonary TB patients from all known sources, and estimated health loss to prevalent TB disease.<h4>Methodology/principal findings</h4>We calculated values for health during illness and treatment, pulmonary impairment after tuberculosis (PIAT), death rates, years-of-life-lost to death, and normal population health. We then compared the lifetime expected QALYs for a cohort of tuberculosis patients with that expected for comparison populations with latent tuberculosis infection and without tuberculosis infection. Persons with culture-confirmed tuberculosis accrued fewer lifetime QALYs than those without tuberculosis. Acute tuberculosis morbidity cost 0.046 QALYs (4% of total) per individual. Chronic morbidity accounted for an average of 0.96 QALYs (78% of total). Mortality accounted for 0.22 QALYs lost (18% of total). The net benefit to society of averting one case of PTB was about 1.4 QALYs.<h4>Conclusions/significance</h4>Tuberculosis, a preventable disease, results in QALYs lost owing to illness, impairment, and death. The majority of QALYs lost from tuberculosis resulted from impairment after microbiologic cure. Successful TB prevention efforts yield more health quality than previously thought and should be given high priority by health policy makers. (Refer to Abstracto S1 for Spanish language abstract).Thaddeus L MillerScott J N McNabbPeter HilsenrathJotam PasipanodyaStephen E WeisPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 4, p e5080 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thaddeus L Miller Scott J N McNabb Peter Hilsenrath Jotam Pasipanodya Stephen E Weis Personal and societal health quality lost to tuberculosis.
description	<h4>Background</h4>In developed countries, tuberculosis is considered a disease with little loss of Quality-Adjusted Life Years (QALYs). Tuberculosis treatment is predominantly ambulatory and death from tuberculosis is rare. Research has shown that there are chronic pulmonary sequelae in a majority of patients who have completed treatment for pulmonary tuberculosis (PTB). This and other health effects of tuberculosis have not been considered in QALY calculations. Consequently both the burden of tuberculosis on the individual and the value of tuberculosis prevention to society are underestimated. We estimated QALYs lost to pulmonary TB patients from all known sources, and estimated health loss to prevalent TB disease.<h4>Methodology/principal findings</h4>We calculated values for health during illness and treatment, pulmonary impairment after tuberculosis (PIAT), death rates, years-of-life-lost to death, and normal population health. We then compared the lifetime expected QALYs for a cohort of tuberculosis patients with that expected for comparison populations with latent tuberculosis infection and without tuberculosis infection. Persons with culture-confirmed tuberculosis accrued fewer lifetime QALYs than those without tuberculosis. Acute tuberculosis morbidity cost 0.046 QALYs (4% of total) per individual. Chronic morbidity accounted for an average of 0.96 QALYs (78% of total). Mortality accounted for 0.22 QALYs lost (18% of total). The net benefit to society of averting one case of PTB was about 1.4 QALYs.<h4>Conclusions/significance</h4>Tuberculosis, a preventable disease, results in QALYs lost owing to illness, impairment, and death. The majority of QALYs lost from tuberculosis resulted from impairment after microbiologic cure. Successful TB prevention efforts yield more health quality than previously thought and should be given high priority by health policy makers. (Refer to Abstracto S1 for Spanish language abstract).
format	article
author	Thaddeus L Miller Scott J N McNabb Peter Hilsenrath Jotam Pasipanodya Stephen E Weis
author_facet	Thaddeus L Miller Scott J N McNabb Peter Hilsenrath Jotam Pasipanodya Stephen E Weis
author_sort	Thaddeus L Miller
title	Personal and societal health quality lost to tuberculosis.
title_short	Personal and societal health quality lost to tuberculosis.
title_full	Personal and societal health quality lost to tuberculosis.
title_fullStr	Personal and societal health quality lost to tuberculosis.
title_full_unstemmed	Personal and societal health quality lost to tuberculosis.
title_sort	personal and societal health quality lost to tuberculosis.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/f900324dd1ab44a69c4f674d64a9bf64
work_keys_str_mv	AT thaddeuslmiller personalandsocietalhealthqualitylosttotuberculosis AT scottjnmcnabb personalandsocietalhealthqualitylosttotuberculosis AT peterhilsenrath personalandsocietalhealthqualitylosttotuberculosis AT jotampasipanodya personalandsocietalhealthqualitylosttotuberculosis AT stepheneweis personalandsocietalhealthqualitylosttotuberculosis
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Personal and societal health quality lost to tuberculosis.

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