The return on investment of TB contact tracing in New York City

Setting In 2013, the New York City Health Department analysed its TB contact tracing programme. Despite long-term declines, TB remained a persistent public health issue in New York City, necessitating continued investment in prevention strategies. Objectives The aim was to evaluate the financial and public health impact of the TB contact tracing programme by conducting a return-on-investment (ROI) analysis. Design The study measured programme costs - including personnel, diagnostics, and follow-up care - against projected savings from averted TB cases. A sensitivity analysis was conducted to assess the impact of varying progression rates from TB infection (TBI) to active TB. Results The programme identified 3,250 contacts and prevented 64 potential TB cases through early detection and TBI treatment. This resulted in a 95.13% ROI, meaning that for every dollar invested, nearly another dollar was saved. The ROI increased under assumptions of higher TBI progression rates, reinforcing the programme's cost-effectiveness. Conclusion Contact tracing plays a critical role in TB control, especially in urban areas with higher incidence. The evaluation supports sustained investment in public health infrastructure and demonstrates that the model can be applied to other infectious disease programmes for targeted prevention and early intervention.