Table 1. Costs of components associated with diagnosis and treatment of drug sensitive, multi-drug resistant and extensively drug resistant tuberculosis.
Cost Component | Cost ($US) | Source |
Inpatient stay (per day) | BCH expenditure reports, Department of Health, BCH statistical reports, staff interviews | |
Capital costs (Buildings and Equipment) | $4.70 | |
Nursing & Medical staff | $18.42 | |
Support staff (OT, PT, Dietician, Psychologist, Data Capturer, etc) | $4.77 | |
Administrative staff | $2.93 | |
Staff overhead (excluding administrative staff) | $7.20 | |
Ancillary (Kitchen & Laundry) | $9.23 | |
Recurrent medical consumables | $3.91 | |
Non personnel recurrent overheads (utilities and other general supplies) | $4.93 | |
Total | $56.07 | |
Outpatient visit (per visit) | BCH expenditure reports, Department of Health, BCH statistical reports, staff interviews | |
Capital costs (Buildings and Equipment) | $1.59 | |
Nursing & Medical staff | $6.13 | |
Support staff (OT, PT, Dietician, Psychologist, Data Capturer, etc.) | $7.15 | |
Administrative staff | $0.97 | |
Staff overhead (excluding administrative staff) | $2.39 | |
Recurrent medical consumables | $1.30 | |
Non personnel recurrent overheads (utilities and other general supplies) | $1.64 | |
Total | $21.16 | |
Clinic visit (per visit) | Langa and Chapel St Clinic expenditure reports, Cape Town City Health, clinic staff interviews | |
Capital costs (Buildings and Equipment) | $0.61 | |
Staff (Nursing, Medical and General administrative staff) | $4.44 | |
Recurrent medical consumables | $0.90 | |
non personnel recurrent overheads (utilities and other general supplies) | $0.69 | |
Total | $6.64 | |
10 minute DOTS worker visit (per visit) | $1.10 | Provincial government salary scales |
Drugs | BCH pharmacy, Cape Town City Health | |
DS-TB | ||
2 mth Intensive (RHZE) | $16.77 | |
4 mth Continuation (RH) | $20.96 | |
DS-TB Retreatment | ||
3 mth Intensive (RHZES) | $135.45 | |
5 mth Continuation (RHE) | $53.03 | |
MDR-TB | ||
6 mth Intensive (Km-Z-Mxf-Eto-Trd) | $1,438.03 | |
18 mth Continuation (Z-Mxf-Eto-Trd) | $3,671.48 | |
XDR-TB Primary | ||
6 mth Intensive (Cm-Z-Mxf-Eto-Trd-PAS-Cfz) | $5,272.91 | |
18 mth Continuation (Cm-Z-Mxf-Eto-Trd-PAS-Cfz) | $15,015.62 | |
XDR-TB Acquired | ||
6 mth Intensive (Cm-Z-Mxf-Clm-Aug-hdH-PAS-Cfz) | $4,884.80 | |
18 mth Continuation (Z-Mxf-Clm-Aug-hdH-PAS-Cfz) | $13,406.14 | |
Tests | National Health Laboratory Services, Groote Schuur Hospital, WHO | |
Auramine Fluorescent Smear Microscopy | $3.71 | |
MGIT 960 liquid Culture | $14.02 | |
Xpert MTB-RIF | $21.39 | |
1st line DST (Line Probe Assay) | $26.74 | |
2nd line DST for 4 drugs (MGIT 960 liquid culture) | $37.83 | |
Chest X-ray | $31.91 | |
Audiogram | $25.60 | |
Liver function (Potassium, Urea, Creatinine) | $15.05 | |
Kidney function (ALT, AST, Bilirubin) | $10.86 | |
Thyroid function | $20.89 | |
HIV Rapid screening test | $5.26 | |
Other HIV associated tests (CD4 count, viral load) | $51.75 | |
Specimen transport | Department of Transport, BCH expenditure reports, staff interviews | |
Capital | $0.28 | |
Recurrent cost | $1.03 | |
Personnel | $1.40 | |
Total | $2.72 | |
Surgery | Groote Schuur Hospital | |
Pneumonectomy | $5,549.36 | |
Death i.e. Removal of body from premises | $70.92 | BCH financial department |
DS-TB - Drug sensitive tuberculosis, MDR-TB – Multi-drug resistant tuberculosis, XDR-TB – Extensively Drug-resistant tuberculosis, ADR - Adverse Drug reaction, OT - Occupational Therapist, PT - Physiotherapist, BCH – Brooklyn Chest Hospital, DOTS – Directly Observed Treatment Short Course, MGIT – Mycobacterial Growth In-tube, DST – Drug susceptibility test, AST - aspartate aminotransferase, ALT - alanine aminotransferase, R - Rifampicin, H - Isoniazid, Z - Pyrazinamide, E - Ethambutol, S - Streptomycin, Km – Kanamycin, Mxf - Moxifloxacin, Eto - Ethionamide, Trd – Terizidone, Cm - Capreomycin, PAS – para-amionsalicylic acid, Cfz – Clofazimine, Clm-Clarithromycin, Aug - Augmentin, hdH - high dose Isoniazid.