Table 1. Case detection, total cohort cost and costs per patient diagnosed for Xpert-for-all and 3 example triage pathways.
Algorithm and scenarios | Cohort | Number of persons in Cohort with TB | Total TB cases detected | % of TB cases | Cohort Diagnostic Costs (US$2011) | Reduction in cohort diagnostic cost | Diagnostic cost per TB case detected (US$ 2011) | Treatment Costs (US$ 2011) | Total Costs ($2011) | Reduction in total cost | Total cost per TB case detected (US$ 2011) |
UGANDA | |||||||||||
Xpert for all persons with presumptive TB | |||||||||||
Tuberculosis (all) | 959 | 912 | 95% | 195294 | Baseline | 214 | 213602 | 408895 | Baseline | 448 | |
No Tuberculosis | 9041 | ||||||||||
MDR TB | 18 | 16 | 90% | ||||||||
Triage example 1. 100% sensitivity, 75% specificity, cost $5; if positive followed by Xpert. | |||||||||||
Tuberculosis (all) | 959 | 912 | 95% | 112368 | 42% | 123 | 200643 | 313012 | 23% | 343 | |
MDR TB | 18 | 16 | 90% | ||||||||
Triage example 2. 95% sensitivity, 75% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 959 | 895 | 93% | 112204 | 43% | 125 | 197046 | 309250 | 24% | 345 | |
MDR TB | 18 | 16 | 88% | ||||||||
Triage example 3. 85% sensitivity, 85% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 959 | 853 | 89% | 94299 | 52% | 111 | 186160 | 280460 | 31% | 329 | |
MDR TB | 18 | 15 | 84% | ||||||||
INDIA | |||||||||||
Xpert for all persons with presumptive TB | |||||||||||
Tuberculosis (all) | 695 | 684 | 99% | 141835 | Baseline | 207 | 273885 | 415720 | Baseline | 607 | |
No Tuberculosis | 9305 | ||||||||||
MDR TB | 36 | 33 | 93% | ||||||||
Triage example 1. 100% sensitivity, 75% specificity, cost $5; if positive followed by Xpert. | |||||||||||
Tuberculosis (all) | 695 | 684 | 99% | 93458 | 34% | 137 | 255064 | 348521 | 16% | 509 | |
MDR TB | 36 | 33 | 93% | ||||||||
Triage example 2. 95% sensitivity, 75% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 695 | 677 | 97% | 93487 | 34% | 138 | 252267 | 345754 | 17% | 511 | |
MDR TB | 36 | 33 | 92% | ||||||||
Triage example 3. 85% sensitivity, 85% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 695 | 653 | 94% | 80373 | 43% | 123 | 241119 | 321493 | 23% | 492 | |
MDR TB | 36 | 32 | 89% | ||||||||
SOUTH AFRICA | |||||||||||
Xpert for all persons with presumptive TB | |||||||||||
Tuberculosis (all) | 956 | 910 | 95% | 174726 | Baseline | 192 | 811040 | 985767 | Baseline | 1083 | |
No Tuberculosis | 9044 | ||||||||||
MDR TB | 92 | 82 | 90% | ||||||||
Triage Example 1. 100% sensitivity, 75% specificity, cost $5; if positive followed by Xpert. | |||||||||||
Tuberculosis (all) | 956 | 910 | 95% | 107272 | 39% | 118 | 771254 | 878526 | 11% | 965 | |
MDR TB | 92 | 82 | 90% | ||||||||
Triage example 2. 95% sensitivity, 75% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 956 | 893 | 93% | 107103 | 39% | 120 | 757378 | 864481 | 12% | 968 | |
MDR TB | 92 | 81 | 88% | ||||||||
Triage example 3. 85% sensitivity, 85% specificity, cost $5 | |||||||||||
Tuberculosis (all) | 956 | 851 | 89% | 91207 | 48% | 107 | 716733 | 807940 | 18% | 949 | |
MDR TB | 92 | 77 | 84% |
% prevalence of smear-positive TB. For a cohort of 10 000 persons with presumptive TB with 5
= multi-drug resistant tuberculosis. MDR TB
= GeneXpert MTB/RIF assay. Xpert