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Comparing multidrug-resistant tuberculosis patient costs under molecular diagnostic algorithms in South Africa
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du Toit, E., Squire, S. B., Dunbar, R., Machekano, R., Madan, Jason, Beyers, N. and Naidoo, P. (2015) Comparing multidrug-resistant tuberculosis patient costs under molecular diagnostic algorithms in South Africa. The international journal of tuberculosis and lung disease, 19 (8). pp. 960-968. doi:10.5588/ijtld.14.0703
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Official URL: http://dx.doi.org/10.5588/ijtld.14.0703
Abstract
SETTING: Ten primary health care facilities in Cape Town, South Africa, 2010–2013.
OBJECTIVE: A comparison of costs incurred by patients in GenoType® MDRTBplus line-probe assay (LPA) and Xpert® MTB/RIF-based diagnostic algorithms from symptom onset until treatment initiation for multidrug-resistant tuberculosis (MDR-TB).
METHODS: Eligible patients identified from laboratory and facility records were interviewed 3–6 months after treatment initiation and a cost questionnaire completed. Direct and indirect costs, individual and household income, loss of individual income and change in household income were recorded in local currency, adjusted to 2013 costs and converted to $US.
RESULTS: Median number of visits to initiation of MDR-TB treatment was reduced from 20 to 7 (P < 0.001) and median costs fell from US$68.1 to US$38.3 (P = 0.004) in the Xpert group. From symptom onset to being interviewed, the proportion of unemployed increased from 39% to 73% in the LPA group (P < 0.001) and from 53% to 89% in the Xpert group (P < 0.001). Median household income decreased by 16% in the LPA group and by 13% in the Xpert group.
CONCLUSION: The introduction of an Xpert-based algorithm brought relief by reducing the costs incurred by patients, but loss of employment and income persist. Patients require support to mitigate this impact.
| Item Type: | Journal Article | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Tuberculosis -- Diagnosis -- Cost effectiveness, Tuberculosis -- Diagnosis -- Cape Town (South Africa), Tuberculosis -- Diagnosis -- Interviews | ||||||||
| Journal or Publication Title: | The international journal of tuberculosis and lung disease | ||||||||
| Publisher: | International Union against Tuberculosis and Lung Disease,Union Internationale contre la Tuberculose et les Maladies Respiratoires | ||||||||
| ISSN: | 1815-7920 | ||||||||
| Official Date: | 2015 | ||||||||
| Dates: |
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| Volume: | 19 | ||||||||
| Number: | 8 | ||||||||
| Page Range: | pp. 960-968 | ||||||||
| DOI: | 10.5588/ijtld.14.0703 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Access rights to Published version: | Open Access | ||||||||
| Funder: | United States. Agency for International Development (USAID) | ||||||||
| Grant number: | TREAT TB – Agreement No. GHN -A-00-08-00004-00 |
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