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Table 3 Unit costs (in US$) of 1000Ā TB suspects screening, comparing smear plus culture and smear plus Detect-TB used in tree decision model

From: Smear plus Detect-TB for a sensitive diagnosis of pulmonary tuberculosis: a cost-effectiveness analysis in an incarcerated population

Ā 

Smear plus culture

Smear plus Detect-TB

Total cases TB

53

48

A health service costs (in US$)

Laboratory costs a

Laboratory costs

3,283

13,067

Investment costs

123

194

Running costs

12,333

12,833

Treatment costs (outpatients)

3,819

337

Treatment costs (inpatients)

3,690

328

Treatment costs (outpatients/inpatients)

7,508

665

Diagnostic service costs per day a

Staff costs per activity-based costing

1,158

77

B1. Patient cost (outpatient) d

Travel

24

2

Food

100

7

Income loss

175

12

B2. Patient cost (inpatient) d

Travel

0

0

Food

0

0

Income loss

175

12

Total patient costs

299,000

19,933

Total health service costs

1,180.748

103,926

Total screening costs in 1000Ā TB cases

1,479.748

123,859

  1. aFor each procedure, costs were attributed based on procedure costs of the Brazilian public health system (US$ 1.4 for smear and US$ 1.9 for culture) and from CDCT/FEPPS (US$ 11.7 for Detect-TB), assuming investment laboratory equipment for 5Ā 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$2,860 per year. cThe days of hospitalization were considered as the same as the days spent on each laboratory procedure. The time spent on each laboratory procedure until access to the result of the laboratory technique was assumed to be 2Ā days for smear plus Detect-TB and 30Ā days for smear plus culture. Total treatment included clinical officer and hospital costs, assuming US$ 0.22 cost per pill, using 3 pills for day, during 180Ā 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 hospitalized patients (4Ā months) 4 smear and 4 chest radiograph were performed, and during the treatment of outpatients (6Ā months) 6 smear and 6 chest radiograph were performed, following the Brazilian recommendations for treatment (Tuberculose 2004); dTravel for smear strategies was considered as 30Ā days for smear plus culture strategy; and 2Ā days for smear plus Detect- TB. Food and income loss for smear strategies was considered as 30Ā days for smear plus culture strategy; and 2Ā days for smear plus Detect- TB. The health service costs analysis was based on processing 50 smear slides, 86 samples for each PCR (Detect- TB) and 14 cultures per day. Smear plus culture and Detect- TB 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.