Trial reportBulletin of the World Health Organization2020
Economic evaluation of short treatment for multidrug-resistant tuberculosis, Ethiopia and South Africa: the STREAM trial.
Trial report in Bulletin of the World Health Organization, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
What it found
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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
18 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Effectiveness and Safety of Bedaquiline-Containing Modified Shorter Regimens for Multidrug- or Rifampicin-Resistant Tuberculosis: A Single-Arm Meta-Analysis.Pathogens (Basel, Switzerland) · 2026Pooled it
- Financial burden of tuberculosis diagnosis and treatment for patients in Ethiopia: a systematic review and meta-analysis.BMC public health · 2024Pooled it
- A systematic review of economic evaluations of pharmacological treatments for active tuberculosis.Frontiers in public health · 2024Pooled it
- A systematic review of scope and quality of health economic evaluations conducted in Ethiopia.Health policy and planning · 2022Pooled it
- Evaluation of two short standardised regimens for the treatment of rifampicin-resistant tuberculosis (STREAM stage 2): an open-label, multicentre, randomised, non-inferiority trial.Lancet (London, England) · 2022Trial
- Health-Service Costs for the Treatment of Multidrug-Resistant/Rifampicin-Resistant Tuberculosis in South African Children: Application of a Real-World Dataset.PharmacoEconomics · 2026Article
- Existing Evidence from Economic Evaluations of Antimicrobial Resistance-A Systematic Literature Review.Antibiotics (Basel, Switzerland) · 2025Review
- Determinants of treatment success and cost implications in MDR/RR-TB patients: a prospective cohort study in China.Scientific reports · 2025Article
- Designing tuberculosis elimination framework through participatory processes in Ethiopia: Results from stakeholders' discussions.PloS one · 2025Article
- Article
- Cost of treatment support for multidrug-resistant tuberculosis using patient-centred approaches in Ethiopia: a model-based method.Infectious diseases of poverty · 2023Article
- Adverse drug reactions and associated factors in multidrug-resistant tuberculosis: A retrospective review of patient medical records at Mbarara Regional Referral Hospital, Uganda.SAGE open medicine · 2023Article
- Efficiency of TB service provision in the public and private health sectors in Ethiopia.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Epidemiological profile of multidrug-resistant and extensively drug-resistant Mycobacterium Tubrculosis among Congolese patients.Annals of clinical microbiology and antimicrobials · 2021Article
- Synergy between government and non-governmental organizations in health: WHO and the Union collaboration in tuberculosis control.Journal of clinical tuberculosis and other mycobacterial diseases · 2021Article
- Article
- Challenges in Tuberculosis Clinical Trials in the Face of the COVID-19 Pandemic: A Sponsor's Perspective.Tropical medicine and infectious disease · 2020Article
- Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveTo investigate cost changes for health systems and participants, resulting from switching to short treatment regimens for multidrug-resistant (MDR) tuberculosis.
methodsWe compared the costs to health systems and participants of long (20 to 22 months) and short (9 to 11 months) MDR tuberculosis regimens in Ethiopia and South Africa. Cost data were collected from participants in the STREAM phase-III randomized controlled trial and we estimated health-system costs using bottom-up and top-down approaches. A cost-effectiveness analysis was performed by calculating the incremental cost per unfavourable outcome avoided.
findingsHealth-care costs per participant in South Africa were 8340.7 United States dollars (US$) with the long and US$ 6618.0 with the short regimen; in Ethiopia, they were US$ 6096.6 and US$ 4552.3, respectively. The largest component of the saving was medication costs in South Africa (67%; US$ 1157.0 of total US$ 1722.8) and social support costs in Ethiopia (35%, US$ 545.2 of total US$ 1544.3). In Ethiopia, trial participants on the short regimen reported lower expenditure for supplementary food (mean reduction per participant: US$ 225.5) and increased working hours (i.e. 667 additional hours over 132 weeks). The probability that the short regimen was cost-effective was greater than 95% when the value placed on avoiding an unfavourable outcome was less than US$ 19 000 in Ethiopia and less than US$ 14 500 in South Africa.
conclusionThe short MDR tuberculosis treatment regimen was associated with a substantial reduction in health-system costs and a lower financial burden for participants.
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