Trial reportBMJ global health2025
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.
Trial report in BMJ global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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
2 citing papers in PubMed.
- Diagnostic completeness: the missing link in antimicrobial stewardship in low- and middle-income countries.Journal of global health · 2026Article
- National Implementation of a Tuberculosis Sample Referral Network to Expand Access to Molecular Diagnosis in the Republic of Congo: Pilot Evaluation and Programmatic Analysis (2023-2025).Tropical medicine and infectious disease · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
backgroundIn low- and middle-income countries (LMICs), tuberculosis (TB) regained its status as the leading cause of death from a single infectious agent in 2023, surpassing COVID-19. Rapid and accurate diagnosis is critical, with decentralised diagnostic strategies offering a promising solution. Although decentralised diagnostic strategies have been proven cost-effective, further evidence is needed on affordability and equity in high-burden settings. This study, part of a multicentre real-world cluster-randomised controlled trial (cRCT), assessed implementation costs and out-of-pocket (OOP) expenditures across socioeconomic status (SES) groups from a societal perspective.
methodsThe TB-CAPT Core trial compared decentralised point-of-care TB testing using the Molbio Truenat platform (intervention) with the hub-and-spoke Xpert MTB/RIF Ultra model (control) in Tanzania and Mozambique. Economic data were collected as part of the trial along with asset ownership information using an equity tool. Multiple correspondence analysis was used to construct an asset index for each country. Extended cost-effectiveness analysis estimated incremental participant costs for TB diagnosis and health outcomes (number of participants who initiated treatment within seven and sixty days) across SES groups. Distributional cost-effectiveness analysis assessed facility-based diagnostic cost per treatment initiated from a societal perspective across SES groups. Regression analyses explored the intervention's impact on direct, indirect and total costs.
resultsAverage OOP expenditures were lower in the intervention arm (US$8.82) than in the control group (US$13.61). Regression analysis confirmed a significant cost reduction. Least poor participants experienced greater cost-savings (-US$6.36 vs -US$2.93), while the poorest had a higher number of TB treatment initiations within 7 days of diagnosis (poorest vs least poor: 28 vs 8). The incremental cost-effectiveness ratio for the poorest group was US$778, whereas for the other two groups, the intervention showed higher treatment initiation (52 vs 36 for middle, 33 vs 25 for least poor) at lower costs than the standard of care.
conclusionThe intervention reduced patient costs and improved outcomes across SES groups. Decentralised TB testing with the Molbio Truenat platform is both cost-saving and more effective and cost-effective compared with a hub-and-spoke model in Mozambique and Tanzania.
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