{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:16:12Z","timestamp":1787019372761,"version":"build-2736575974"},"reference-count":50,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Universal community-based tuberculosis (TB) screening in high-burden settings is resource-intensive and inefficient, frequently missing cases and leading to suboptimal resource allocation. Integrating routine surveillance data with geospatial analytics offers a promising approach to enhance the efficiency and cost-effectiveness of active case finding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate whether integrating Uganda\u2019s electronic Case-Based Surveillance System (eCBSS) data with geospatial hotspot analytics improves the efficiency, yield and cost-effectiveness of integrated TB case finding (CAST+) in Eastern Uganda<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We conducted a quasi-experimental before-and-after study comparing a universal community screening campaign (September 2022) with a geospatially targeted campaign (March 2024) in Eastern Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We analysed routine eCBSS data from 166 diagnostic and treatment units using a sequential two-stage geospatial approach in Quantum Geographic Information System (QGIS). Statistically significant hotspot parishes were identified using the Getis-Ord Gi* statistic (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.05), followed by the prioritisation of villages reporting\u2009&gt;\u20092 bacteriologically confirmed TB cases (March 2023\u2013February 2024). Comparative effectiveness was assessed with a cluster-adjusted chi-square test (Rao-Scott correction). Cost-effectiveness was evaluated from the provider perspective using inflation-adjusted 2024 USD costs, disability-adjusted life years (DALYs) averted, cost-effectiveness ratios (CERs) and incremental cost-effectiveness ratios (ICERs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The targeted strategy screened 49,373 individuals across 313 villages, compared with 627,082 in 3252 villages under the universal campaign, representing a 92.1% reduction in screening volume. Despite this, TB yield increased by 10% (1.68%\u20131.85%;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Total inflation-adjusted costs declined by 90.9% (from USD 62,804 to USD 5704), unit cost per TB case fell by 55.2% (USD 82.20\u2013USD 36.80), and cost per DALY averted decreased from USD 4.72 to USD 2.11 (ICER: USD 5.39\u2009per DALY averted). All diagnosed TB cases were initiated on treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>eCBSS-guided geospatial targeting improved efficiency, precision and cost-effectiveness of TB screening, supporting a shift from universal to targeted TB case finding, and provides programmatic evidence for high-value public health interventions in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20499361261456596","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T07:32:23Z","timestamp":1781163143000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Precision geospatial targeting for cost-effective tuberculosis case finding in Eastern Uganda: a quasi-experimental study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1548-2684","authenticated-orcid":false,"given":"Clark Joshua","family":"Brianwong","sequence":"first","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala 72052, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Cherotin","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lwanga Sssekiswa","family":"Zimwanguyiza","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Kyakuwa","family":"Jjuuko","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Ntege","family":"Nahirya","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Mugume","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dithan","family":"Kiragga","sequence":"additional","affiliation":[{"name":"Medical and psychosocial, Baylor College of Medicine Children\u2019s Foundation Uganda, Kampala, Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(22)00359-7"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtldopen.23.0624"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08951-0"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2024.107325"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00687-2"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-024-09798-9"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-019-4616-2"},{"key":"e_1_3_4_9_2","first-page":"154","article-title":"Outcomes of a clinical diagnostic algorithm for management of ambulatory smear and Xpert MTB\/Rif negative HIV infected patients with presumptive pulmonary TB in Uganda: a prospective study","volume":"23","author":"Walusimbi S","year":"2016","unstructured":"Walusimbi S, et al. 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