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Table 5 Frequencies of laboratory tests and patient monitoring visits per patient and model according to the Nigerian DR-TB guidelines

From: Cost of three models of care for drug-resistant tuberculosis patients in Nigeria

  

Model A

Model B

Model C

 

Unit

Frequency in intensive phase

Frequency in continuation phase

Frequency in intensive phase

Frequency in continuation phase

Frequency in intensive phase

Frequency in continuation phase

I. DR-TB Diagnostic tests

 GeneXpert

Test

1

1

1

 Sputum smear

Smear

1

1

1

 Culture – Liquid

Test

1

1

1

 1st and 2nd line DST - Solid culture

Test

1

1

1

II. Baseline tests & routine laboratory tests

 X-ray

Test

2

2

2

2

2

2

 ENT consultation

Consult

1

1

1

 Audiometry test

Test

9

9

9

 E, U, Cr

Test

8

8

8

 Thyroid function test

Test

2

2

2

2

2

2

 LFT

Test

3

4

3

4

3

4

 HIV Test

Test

1

1

1

 Pregnancy test

Test

0.5

0.5

0.5

III. Drugs

 Pyrazinamide 400 mg

Tablet

972

1488

972

1488

972

1488

 Kanamycin 1 g vial

Vial

243

243

243

 Levofloxacin 250 mg

Caplet

729

1116

729

1116

729

1116

 Prothionamide 250 mg

Tablet

729

1116

729

1116

729

1116

 Cycloserine 250 mg

Capsule

729

1116

729

1116

729

1116

 Pyridoxine 10 mg

Tablet

729

1116

729

1116

729

1116

IV. Inpatient stay

 Inpatient hospitalization days

Bed day

243

152

V. Outpatient consultations and supervision

 Consultation at treatment center /Monthly clinic visit

Visit

12

3

12

8

12

 Visits to collect medication at DOT center/ DOT at DOT center

Visit

24

6

24

16

24

 Home visit - by DOT officer

Home visit

24

91

24

243

24

 Home visit by DR TB focal person

Home visit

12

3

12

8

12

 Home visit by TBL supervisor

Home visit

12

3

12

8

12

 Quarterly state team meeting

Meeting

4

1

4

3

4

 Quarterly state team home visit

Home visit

4

2

4

2

4

VI. Follow-up DR-TB testing

 Sputum smear

Smear

8

12

8

12

8

12

 Culture - Liquid

Test

8

6

8

6

8

6

 1st and 2nd line DST - Solid culture

Test

0.2^

0

0.2^

0

0.2a

0

  1. List of abbreviations: Cr creatinine, DOT directly observed treatment, DR drug resistant, DST drug susceptibility testing, E electrolytes, ENT ear nose throat, TB tuberculosis, TBL tuberculosis and leprosy, U urea, LFT liver function test,
  2. aA conservative estimate of DR-TB patients who are still culture positive after four months of DR-TB treatment and thus require repeat second-line DST