| Title: | Is introducing rapid culture into the diagnostic algorithm of smear-negative tuberculosis cost-effective? (2014) |
| Authors: | Martine Audibert, Author ; Maryline Bonnet ; Jeremiah Chakaya, Author ; Helena Huerga, Author ; Joseph Sitienei, Author ; Francis Varaine, Author ; Nadia Yakhelef, Author |
| In : | International Journal of Tuberculosis and Lung Disease (Vol.18 N° 5, May 2014) |
| Article on page: | pp. 541-546 |
| Languages: | French |
| Descriptors: |
[Eurovoc] GEOGRAPHY > Africa > sub-Saharan Africa > East Africa > Kenya [Eurovoc] SOCIAL QUESTIONS > health > health policy > health costs [Eurovoc] SOCIAL QUESTIONS > health > illness > infectious disease |
| Tags: | economic evaluation ; smear-negative pulmonary ; TB diagnosis ; health technology assessment |
| Abstract: |
SETTING: In 2007, the World Health Organization recommended introducing rapid Mycobacterium tuberculosis culture into the diagnostic algorithm of smearnegative pulmonary tuberculosis (TB).
OBJECTIVE: To assess the cost-effectiveness of introducing a rapid non-commercial culture method (thinlayer agar), together with Löowenstein-Jensen culture to diagnose smear-negative TB at a district hospital in Kenya. DESIGN: Outcomes (number of true TB cases treated) were obtained from a prospective study evaluating the effectiveness of a clinical and radiological algorithm (conventional) against the alternative algorithm (conventional plus M. tuberculosis culture) in 380 smearnegative TB suspects. The costs of implementing each algorithm were calculated using a 'micro-costing' or 'ingredient-based' method. We then compared the cost and effectiveness of conventional vs. culture-based algorithms and estimated the incremental cost-effectiveness ratio. RESULTS : The costs of conventional and culture-based algorithms per smear-negative TB suspect were respectively E39.5 and E144. The costs per confirmed and treated TB case were respectively E452 and E913. The culture-based algorithm led to diagnosis and treatment of 27 more cases for an additional cost of E1477 per case. CONCLUSION: Despite the increase in patients started on treatment thanks to culture, the relatively high cost of a culture-based algorithm will make it difficult for resource-limited countries to afford. |
| Doi : |
DOI : 10.5588/ijtld.13.0630 
|
| Axe de recherche : | Trajectoires de développement durable |
| Link for e-copy: | https://halshs.archives-ouvertes.fr/halshs-00991625 |
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