ArticlePLOS global public health2025
Decentralized TB diagnostic testing with Truenat MTB Plus and MTB-RIF Dx vs. hub-and-spoke GeneXpert MTB/RIF Ultra in Mozambique and Tanzania: a cost and cost-effectiveness analysis.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis 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.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Near point-of-care nucleic acid amplification tests (NPOC-NAATs) using respiratory specimens for detection of pulmonary tuberculosis.The Cochrane database of systematic reviews · 2026Pooled it
- User perspectives on the Molbio Truenat platform and tuberculosis assays for decentralised testing in Mozambique and Tanzania.BMJ global health · 2026Trial
- An extended cost-effectiveness analysis of decentralised TB diagnostic testing with Molbio Truenat MTB/RIF versus hub-and-spoke GeneXpert MTB/RIF in Mozambique and Tanzania.BMJ global health · 2025Trial
- Diagnostic completeness: the missing link in antimicrobial stewardship in low- and middle-income countries.Journal of global health · 2026Article
- Combining ADA, IFN-γ, and IL-6 as host biomarkers enhances diagnosis of paucibacillary and extrapulmonary tuberculosis.Communications medicine · 2026Article
- Article
- Cost and impact of decentralized tuberculosis testing: a modeling analysis of price thresholds for molecular instruments in high-burden settings.EClinicalMedicine · 2026Article
- Evaluating the health impact, health-system costs and cost-effectiveness of using TrueNat on stool samples compared to usual care for the diagnosis of paediatric tuberculosis in primary care settings: A modelling analysis.PLOS global public health · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
In low-and middle-income countries, missed or delayed tuberculosis (TB) diagnoses contribute to avoidable morbidity, mortality, and transmission. Decentralized testing platforms, such as the Molbio Truenat, may offer solutions by providing accurate point-of-care testing, improving access, and lowering out-of-pocket costs. Despite these advantages, the overall cost and cost-effectiveness of identifying additional TB cases using the Truenat MTB assays remain inadequately explored and understood. We collected economic data from a multicentre randomized controlled trial of TB testing using decentralized Molbio Truenat platform with MTB Plus and MTB-RIF Dx assays (Truenat MTB assays) versus hub-and-spoke Xpert MTB/RIF Ultra (standard of care) in Tanzania and Mozambique (TB-CAPT Core trial). We estimated facility-based diagnostic cost per participant tested and incremental facility-based diagnostic cost per incremental participant initiating TB treatment within seven and sixty days from enrolment. We used the societal perspective and conducted sensitivity analyses to determine key drivers of cost-effectiveness. The facility-based diagnostic cost per participant initiating treatment within seven days from enrolment in Mozambique was $853(95% uncertainty range: $707, $1072) for hub-and-spoke testing and $690($588, $823) for decentralized testing; in Tanzania costs were $596($485, $746) for hub-and-spoke testing and $592($495, $715) for decentralized testing. At sixty days, costs per treatment initiation were $581($493, $706) for hub-and-spoke vs. $678($576, $811) for decentralized testing in Mozambique, and $391($324, $476) vs. $591($494, $716) in Tanzania. Comparing decentralized to hub-and-spoke testing, the incremental cost per incremental seven-day treatment initiation was $403(-$103, $941) in Mozambique and $580($167, $1638) in Tanzania, and $805(-$10107, $10560) and -$353(-$20299, $20802) for sixty-day treatment initiation, respectively. Utilization (i.e., testing volume) of decentralized equipment was the strongest driver of cost-effectiveness. Decentralized TB testing with Truenat MTB assays is cost-effective relative to hub-and-spoke testing in Mozambique and Tanzania.
Identifiers
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Registered trials
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.