Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro, Brazil
| Autor: | Anália Zuleika de Castro, Jaqueline da Silva Oliveira, Paulo Albuquerque da Costa, Carolyne Lalucha Alves Lima Da Graça, Maurício de Andrade Pérez, Afrânio Lineu Kritski, Maria Claudia Vater, Adriana S. R. Moreira |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty lcsh:Arctic medicine. Tropical medicine Tuberculosis lcsh:RC955-962 Diagnostic methods Sensitivity and Specificity Smear microscopy Sputum smear microscopy 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Pulmonary tuberculosis Interquartile range Internal medicine Cost analysis medicine Humans 030212 general & internal medicine Prospective cohort study Tuberculosis Pulmonary 030505 public health Diagnostic Tests Routine business.industry Sputum Mycobacterium tuberculosis medicine.disease Triage Test (assessment) Infectious Diseases Predictive value of tests Costs and Cost Analysis Female Parasitology 0305 other medical science business Xpert MTB/RIFtest |
| Zdroj: | Revista da Sociedade Brasileira de Medicina Tropical v.51 n.5 2018 Revista da Sociedade Brasileira de Medicina Tropical Sociedade Brasileira de Medicina Tropical (SBMT) instacron:SBMT Revista da Sociedade Brasileira de Medicina Tropical, Vol 51, Iss 5, Pp 631-637 Revista da Sociedade Brasileira de Medicina Tropical, Volume: 51, Issue: 5, Pages: 631-637, Published: OCT 2018 |
| ISSN: | 1678-9849 0037-8682 |
| Popis: | INTRODUCTION: The molecular test Xpert MTB/RIF (Xpert) has been recommended for use in the diagnosis of pulmonary tuberculosis (PTB); however, data on the cost of incorporating it under routine conditions in high-burden countries are scarce. The clinical impact and costs incurred in adopting the Xpert test in routine PTB diagnosis was evaluated in a prospective study conducted from November 2012 to November of 2013, in the City of Rio de Janeiro, Brazil. METHODS: The diagnostic and therapeutic cascade for TB treatment was evaluated using Xpert in the first stage (S1), and sputum smear microscopy (SSM) in the second stage (S2). The mean costs associated with each diagnostic test were calculated including equipment, human resources, supplies, and infrastructure. RESULTS: We included 232 subjects with probable TB (S1 = 87; S2 = 145). The sensitivities of Xpert and SSM were 91.7% (22/24) and 79.1% (34/43), respectively. The median time between triage and TB treatment initiation in S1 (n = 24) was 14.5 days (IQR 8-28.0) and in S2 (n = 43) it was 8 days [interquartile range (IQR) 6-12.0]. The estimated mean costs per examination in S1 and S2 were US$24.61 and US$6.98, respectively. CONCLUSIONS: Compared with SSM, Xpert test showed a greater sensitivity, but it also had a time delay with respect to treatment initiation and a higher mean cost per examination. |
| Databáze: | OpenAIRE |
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