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

## TL;DR

This study evaluates New York City's TB contact tracing program and finds that every dollar invested saves nearly another dollar in averted cases.

## Contribution

The paper provides a financial ROI analysis of TB contact tracing, demonstrating its cost-effectiveness in urban public health.

## Key findings

- The program identified 3,250 contacts and prevented 64 potential TB cases.
- The ROI was 95.13%, indicating significant cost savings from the program.
- Higher TB infection progression rates further increased the ROI, highlighting program effectiveness.

## Abstract

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.

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.

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.

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.

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.