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Table 3 Costs (in US$) of screening 1000 TB suspects, comparing AFB smear plus Culture and AFB smear plus PCR dot-blot

From: Cost-effectiveness analysis of PCR for the rapid diagnosis of pulmonary tuberculosis

 

AFB smear plus Culture

AFB smear plus PCR dot-blot

Total cases TB

128

128

3. A Health Service costs

Labor costs a

Laboratory Costs

3,283

13,067

Investment costs

123

194

Running costs

12,333

12,833

Treatment costs

Treatment costs (ambulatory/outpatients)

1,589

849

Treatment costs (hospitalization/inpatients)

2,686

487

Treatment costs (outpatients and inpatients)

4,275

1,336

Diagnostic Service costs per day a

Cost staff per time spent in each laboratory procedure

1,158

116

3. B1. Patient cost (ambulatory/outpatients) d

Travel

1

1

Food

3

3

Income Loss

12

12

3. B2. Patient cost (hospital/inpatients) d

Travel

0

0

Food

0

0

Income Loss

174.8

18

3. C Total costs for 1000 TB suspects

Total Patient costs

190,800

34,000

Total Health Service costs

5,444,960

1,464,660

Total Screening costs

5,635,760

1,498,660

  1. a For each procedure, costs were attributed based on procedure costs of the Brazilian Public Health System (US$ 1.4 for AFB smear and US$ 1.9 for Culture) and from CDCT/FEPPS (US$ 11.7 for PCR dot-blot), assuming investment laboratory equipment for 5 years; bStaff salary was considered; for laboratory technician, US$2,860 per year; for Laboratory technologist, US$6,400 per year. Staff costs in the laboratory were based on proportional days spent on each laboratory procedure; Staff salary was considered for clinical physician, nurse and radiologist; US$6,400 per year; for the X-RAY technician, salary was US$2,860 per year. cThe days of hospitalization were considered as the same as the days spent on each laboratory procedure. The time spent on each laboratory procedure until access to the result of the laboratory technique was assumed to be 3 days for AFB smear plus in house PCR (PCR dot blot), and 30 days for AFB smear plus Culture. Total treatment included clinical officer and hospital costs, assuming US$ 0.22 cost per pill, using 3 pills for day, during 180 days; hospital room costs, US$ 4.16/day; costs of salary of staff clinical; clinical consultation cost, US$2.52 per patient; clinical nursing consultation, US$2.52 per patient. Assuming that during the treatment of inpatients (4 months) 4 AFB smear and 4 chest radiograph were performed, and during the treatment of outpatients (6 months) 6 AFB smear and 6 chest radiograph were performed, following the Brazilian recommendations for treatment [21];
  2. d Travel for AFB smear strategies was considered as 2 days for AFB smear plus Culture strategy; and 2 days for AFB smear plus PCR dot-blot. Food and income loss for AFB smear strategies was considered as 30 days for AFB smear plus Culture strategy; and 3 days for AFB smear plus PCR dot-blot The health service costs analysis was based on processing 50 AFB smear slides, 86 samples for each in house PCR and 14 cultures per day. AFB smear plus Culture and in house PCR were performed by two trained staff, respectively. Costs of chest physicians were considered the same for all strategies. Running costs were calculated from investments required to examine 1000 smears.
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BMC Infectious Diseases

ISSN: 1471-2334

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