Is introducing rapid culture in the diagnostic algorithm of smear-negative tuberculosis cost-effective? - HAL-SHS - Sciences de l'Homme et de la Société Access content directly
Preprints, Working Papers, ... Year : 2013

Is introducing rapid culture in the diagnostic algorithm of smear-negative tuberculosis cost-effective?

Abstract

Setting: In 2007, WHO recommended introducing rapid Mycobacterium tuberculosis (MTB) culture in the diagnostic algorithm of smear-negative pulmonary tuberculosis (TB). Objective: To assess the cost-effectiveness of the introduction of rapid non-commercial culture method (Thin Layer Agar) together with Löwenstein Jensen culture to diagnose smear-negative TB at a district hospital in Kenya. Design: Effectiveness data (number of true TB cases treated) were obtained from a prospective study evaluating the effectiveness of a clinical and radiological algorithm (conventional) with and without (culture-based) MTB culture in 380 smear-negative TB suspects. The costs of each algorithm were calculated using a "micro-costing" or "ingredient-based" method. The cost and effectiveness was compared between conventional and culture-based algorithms and the incremental cost-effectiveness ratio (ICER) was estimated. Results The cost of conventional and culture-based algorithms (per smear-negative TB case) was 15,026€ (39.5€) and 54,931€ (144€), respectively. The cost per TB confirmed and treated case was 455.3€ and 915.5€, respectively. The culture-based algorithm allowed to diagnose and treat 27 more cases for an additional cost of 39,905€ (1478€ per case). Conclusion MTB culture is cost-effective to diagnose smear-negative pulmonary TB according to WHO standards but did not reduce the cost of overtreatment due to long delay of culture results.
Fichier principal
Vignette du fichier
2013.17.pdf (426.19 Ko) Télécharger le fichier
Origin : Files produced by the author(s)
Loading...

Dates and versions

halshs-00866530 , version 1 (26-09-2013)

Identifiers

  • HAL Id : halshs-00866530 , version 1

Cite

Nadia Yakhelef, Martine Audibert, Francis Varaine, Jeremiah Chakaya, Joseph Sitienei, et al.. Is introducing rapid culture in the diagnostic algorithm of smear-negative tuberculosis cost-effective?. 2013. ⟨halshs-00866530⟩
176 View
263 Download

Share

Gmail Facebook X LinkedIn More