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Comparing multidrug-resistant tuberculosis patient costs under molecular diagnostic algorithms in South Africa

du Toit, E., Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038, Dunbar, R., Machekano, R., Madan, J., Beyers, N. and Naidoo, P. (2015) 'Comparing multidrug-resistant tuberculosis patient costs under molecular diagnostic algorithms in South Africa'. International Journal of Tuberculosis and Lung Disease, Vol 19, Issue 8, pp. 960-968.

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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: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WF Respiratory System > Tuberculosis > WF 205 Epidemiology
WF Respiratory System > Tuberculosis > WF 360 Drug therapy
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.5588/ijtld.14.0703
Depositing User: Lynn Roberts-Maloney
Date Deposited: 22 Oct 2015 09:33
Last Modified: 06 Feb 2018 13:10
URI: http://archive.lstmed.ac.uk/id/eprint/5371

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