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目的:在工业化国家美国和发展中国家南非估算比较直接面视下治疗与常规传统的治疗在减少耐多药结核病传播的成本-效益策略。 方法:利用已发表的数据对概率,费用与健康影响进行Monte Carlo分析。 结果:在两国,直接面视下治疗均为最具优势的策略,既可节约费用,又改善治疗结果,与采用昂贵二线药物的常规治疗比较则更为明显,尤其在南非。 结论:与常规治疗比较,在美国和南非均已证实直接面视下治疗最符合成本-效益策略。随着耐多药结核病的增多和采用昂贵的二线药物可能性增加,节约费用尤为突出(尤其对南非)。发展中国家卫生资源严重紧缺,本文所包括的资料对制定以有限的资源,更有效处理治疗耐多药结核病的策略是有益的。
OBJECTIVE: Cost-benefit strategies to reduce the spread of multidrug-resistant tuberculosis (MDR-TB) in both the United States and developing countries in industrialized countries estimated relatively directly at treatment and conventional conventional treatments. Methods: Monte Carlo analysis of the impact of probability, cost, and health using published data. Results: In both countries, direct face-to-face treatment was the most advantageous strategy that saved costs and improved outcomes, especially in South Africa, when compared with conventional treatment with expensive second-line drugs. CONCLUSIONS: In both the United States and South Africa, treatment with direct face-to-face treatment has demonstrated the most cost-benefit strategy compared with conventional treatment. Cost savings are particularly significant as MDRI-TB increases and the potential for expensive second-line drugs increases (especially in South Africa). The health resources in developing countries are seriously scarce and the information contained in this paper is instrumental in developing a strategy to address the MDR-TB treatment with limited resources.