Table 2.

Monitoring Test Costs, Disability-Adjusted Life Years (DALYs), and Costs Averted per Case Detected

Test, cost per test; complications avoided by detection	Probability that complication is fatal	Disability weight (duration, years)	DALYs averted per abnormal laboratory test result detecteda	Cost of medical care averteda	References
SGOT/SGPT, $6.00
Progression to severe hepatitis from tuberculosis drugsb	0.047	0.209 (0.25)	0.394	$477.00	[23–25]
Creatinine, $3.00
ART overdosage (ART doses lowered because of renal failure)	0.000	0.086 (0.25)	0.022	$53.00	[23, 26]
Glucose, $3.00
Blindness	0.000	0.600 (4.2)	0.136c	$360.00	[23, 27]
Renal failure		0.086 (4.2)	0.007c
Amputation		0.155 (4.2)	0.013c
CBC (hemoglobin, neutrophils, and platelets), $6.00
Grade 3 anemia	0.000	0.093 (1.0)	0.090	$43.00	[6, 23, 28, 29]
Grade 4 anemia	0.009	0.255 (1.0)	0.311	$74.00
Neutropenia	0.028	0.000 (0.0)	0.205	$101.00
Thrombocytopenia	0.008	0.000 (0.0)	0.059	$75.00
Hematocrit (spun), $0.33
Grade 3 anemia	0.000	0.093 (1.0)	0.090	$43.00	[6, 23]
Grade 4 anemia	0.009	0.255 (1.0)	0.311	$74.00

NOTE. All dollar amounts are in US dollars. DALYs are calculated assuming life expectancy of 8.4 years [30]. ART, antiretroviral therapy; CBC, complete blood count; SGOT/SGPT, serum glutamic oxaloacetic transaminase/serum glutamic pyruvic transaminase.

^aFor calculations of DALYs averted, see Table A1 in the Appendix (which appears only in the electronic version of the journal), and for calculations of medical costs averted by early detection, see Tables A2–A4 in the Appendix.

^bNote that ART-related liver disease did not result in any changes in medication.

^cAssumes 0.066 probability of blindness, 0.023 probability of renal failure, and 0.025 probability of amputation; total DALYs averted are 0.156 per case of diabetes detected.