Evidence map›Paper›PMID 38773636›Full record

ArticleCost effectiveness and resource allocation : C/E2024

Cost-effectiveness of TB diagnostic technologies in Ethiopia: a modelling study.

Lelisa Fekadu Assebe, Andargachew Kumsa Erena, Lemmessa Fikadu, Bizuneh Alemu, Yirgalem Shibiru Baruda, Boshen Jiao

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Article in Cost effectiveness and resource allocation : C/E, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

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4citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Lelisa Fekadu AssebeDepartment of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway. lelfekadu1@gmail.com.
Andargachew Kumsa ErenaDisease Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia.
Lemmessa FikaduHealth system strengthening through Performance Based Financing Project, Cordaid, Bahir dar, Ethiopia.
Bizuneh AlemuDepartment of Health Promotion and disease prevention, Oromia Regional Health Bureau, Addis Ababa, Ethiopia.
Yirgalem Shibiru BarudaDepartment of Global Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
Boshen JiaoDepartment of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Funding

Trond Mohn Foundation and NORAD through BCEPS 813596
6 · The paper itself

Abstract

backgroundTuberculosis (TB) is a major threat to public health, particularly in countries where the disease is highly prevalent, such as Ethiopia. Early diagnosis and treatment are the main components of TB prevention and control. Although the national TB guideline recommends the primary use of rapid TB diagnostics whenever feasible, there is limited evidence available that assess the efficiency of deploying various diagnostic tools in the country. Hence, this study aims to evaluate the cost-effectiveness of rapid TB/MDR-TB diagnostic tools in Ethiopia.

methodsA hybrid Markov model for a hypothetical adult cohort of presumptive TB cases was constructed. The following TB diagnostic tools were evaluated: X-pert MTB/RIF, Truenat, chest X-ray screening followed by an X-pert MTB/RIF, TB-LAMP, and smear microscopy. Cost-effectiveness was determined based on incremental costs ($) per Disability-adjusted Life Years (DALY) averted, using a threshold of one times Gross Domestic Product (GDP) per capita ($856). Data on starting and transition probabilities, costs, and health state utilities were derived from secondary sources. The analysis is conducted from the health system perspective, and a probabilistic sensitivity analysis is performed.

resultThe incremental cost-effectiveness ratio for X-pert MTB/RIF, compared to the next best alternative, is $276 per DALY averted, making it a highly cost-effective diagnostic tool. Additionally, chest X-ray screening followed an X-pert MTB/RIF test is less cost-effective, with an ICER of $1666 per DALY averted. Introducing X-pert MTB/RIF testing would enhance TB detection and prevent 9600 DALYs in a cohort of 10,000 TB patients, with a total cost of $3,816,000.

conclusionThe X-pert MTB/RIF test is the most cost-effective diagnostic tool compared to other alternatives. The use of this diagnostic tool improves the early detection and treatment of TB cases. Increased funding for this diagnostic tool will enhance access, reduce the TB detection gaps, and improve treatment outcomes.

Indexed as

Cost-effectivenessEthiopiaMicroscopyRapid TB diagnosticsTuberculosis

Identifiers

PMID38773636
PMCPMC11106958

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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.