ArticlePloS one2018
MDR-TB patients in KwaZulu-Natal, South Africa: Cost-effectiveness of 5 models of care.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Economic burden of multidrug-resistant tuberculosis on patients and households: a global systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Effect of HIV on bedaquiline and delamanid pharmacokinetics in patients with multidrug-resistant TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Trial
- Economic evaluation of short treatment for multidrug-resistant tuberculosis, Ethiopia and South Africa: the STREAM trial.Bulletin of the World Health Organization · 2020Trial
- High non-compliance rate with anti-tuberculosis treatment: a need to shift facility-based directly observed therapy short course (DOTS) to community mobile outreach team supervision in Saudi Arabia.BMC public health · 2019Trial
- Explanatory Modeling of Tuberculosis Treatment Outcomes: The Role of Community Engagement and Clinical Governance.International journal of environmental research and public health · 2026Article
- A historical budget impact and expenditure analysis of meropenem and clavulanate-based treatment for adults with XDR-TB at a specialised TB hospital in South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Article
- Health-Service Costs for the Treatment of Multidrug-Resistant/Rifampicin-Resistant Tuberculosis in South African Children: Application of a Real-World Dataset.PharmacoEconomics · 2026Article
- Actor sensemaking and its role in implementation of the decentralized drug-resistant tuberculosis policy in South Africa.Health policy and planning · 2025Article
- Preventing tuberculosis with community-based care in an HIV-endemic setting: a modelling analysis.Journal of the International AIDS Society · 2024Article
- Cost-consequence analysis of ambulatory clinic- and home-based multidrug-resistant tuberculosis management models in Eswatini.PloS one · 2024Article
- Organisation of care for people receiving drug-resistant tuberculosis treatment in South Africa: a mixed methods study.BMJ open · 2023Article
- Article
- Healthcare worker perceived barriers and facilitators to implementing a tuberculosis preventive therapy program in rural South Africa: a content analysis using the consolidated framework for implementation research.Implementation science communications · 2023Article
- Preventing tuberculosis with community-based care in an HIV-endemic setting: a modeling analysis.medRxiv : the preprint server for health sciences · 2023Article
- Time-to-Treatment Initiation in a Decentralised Community-Care Model of Drug-Resistant Tuberculosis Management in the OR Tambo District Municipality of South Africa.International journal of environmental research and public health · 2023Article
- Cost of treatment support for multidrug-resistant tuberculosis using patient-centred approaches in Ethiopia: a model-based method.Infectious diseases of poverty · 2023Article
- Healthcare worker knowledge, attitudes, and beliefs regarding tuberculosis preventive therapy in rural South Africa: A content analysis using the consolidated framework for implementation research.Research square · 2023Article
- Spatial heterogeneity of extensively drug resistant-tuberculosis in Western Cape Province, South Africa.Scientific reports · 2022Article
- Article
- Diverse clinical and social circumstances: developing patient-centred care for DR-TB patients in South Africa.Public health action · 2021Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundSouth Africa has a high burden of MDR-TB, and to provide accessible treatment the government has introduced different models of care. We report the most cost-effective model after comparing cost per patient successfully treated across 5 models of care: centralized hospital, district hospitals (2), and community-based care through clinics or mobile injection teams.
methodsIn an observational study five cohorts were followed prospectively. The cost analysis adopted a provider perspective and economic cost per patient successfully treated was calculated based on country protocols and length of treatment per patient per model of care. Logistic regression was used to calculate propensity score weights, to compare pairs of treatment groups, whilst adjusting for baseline imbalances between groups. Propensity score weighted costs and treatment success rates were used in the ICER analysis. Sensitivity analysis focused on varying treatment success and length of hospitalization within each model.
resultsIn 1,038 MDR-TB patients 75% were HIV-infected and 56% were successfully treated. The cost per successfully treated patient was 3 to 4.5 times lower in the community-based models with no hospitalization. Overall, the Mobile model was the most cost-effective.
conclusionReducing the length of hospitalization and following community-based models of care improves the affordability of MDR-TB treatment without compromising its effectiveness.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.