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Comparing multidrug-resistant tuberculosis patient costs under molecular diagnostic algorithms in South Africa
- Source :
- The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 19(8)
- Publication Year :
- 2015
-
Abstract
- SETTING: Ten primary health care facilities in Cape Town, South Africa, 2010–2013.\ud \ud 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).\ud \ud 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.\ud \ud 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.\ud \ud 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.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Male
medicine.medical_specialty
Tuberculosis
Primary health care
Antitubercular Agents
Indirect costs
South Africa
Young Adult
Internal medicine
Surveys and Questionnaires
Tuberculosis, Multidrug-Resistant
medicine
Humans
Symptom onset
Aged
Primary Health Care
business.industry
Diagnostic algorithms
Individual income
Middle Aged
medicine.disease
Surgery
Infectious Diseases
Molecular Diagnostic Techniques
Unemployment
Income
Household income
Female
business
After treatment
Algorithms
RC
Subjects
Details
- ISSN :
- 18157920
- Volume :
- 19
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
- Accession number :
- edsair.doi.dedup.....26d4a226815f6e5a9a5393f9895ce4f9