Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra

The World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage. We evaluated the cost-effe...

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Autores: Iem, Vibol|||0000-0001-6155-1402, Bimba, John|||0000-0001-7847-4271, Santos, Victor S., Domínguez, José|||0000-0001-7888-0309, Creswell, Jacob|||0000-0002-4885-940X, Somphavong, Silaphet, Wingfield, Tom, Khan, Jahangir A. M., Cuevas, Luis E..|||0000-0002-6581-0587
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281277
Acceso en línea:https://ddd.uab.cat/record/281277
https://dx.doi.org/urn:doi:10.1186/s12879-023-08330-9
Access Level:acceso abierto
Palabra clave:Cost-effectiveness
Cost-minimization analysis
Pooling
Tuberculosis
Xpert MTB/RIF
Xpert Ultra
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spelling Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultraa cost-effectiveness analysisIem, Vibol|||0000-0001-6155-1402Bimba, John|||0000-0001-7847-4271Santos, Victor S.Domínguez, José|||0000-0001-7888-0309Creswell, Jacob|||0000-0002-4885-940XSomphavong, SilaphetWingfield, TomKhan, Jahangir A. M.Cuevas, Luis E..|||0000-0002-6581-0587Cost-effectivenessCost-minimization analysisPoolingTuberculosisXpert MTB/RIFXpert UltraThe World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage. We evaluated the cost-effectiveness of pooling sputum samples for TB testing by using a fixed amount of 1,000 MTB/RIF or Ultra cartridges. We used the number of people with TB detected as the indicator for cost-effectiveness. Cost-minimization analysis was conducted from the healthcare system perspective and included the costs to the healthcare system using pooled and individual testing. There was no significant difference in the overall performance of the pooled testing using MTB/RIF or Ultra (sensitivity, 93.9% vs. 97.6%, specificity 98% vs. 97%, p-value > 0.1 for both). The mean unit cost across all studies to test one person was 34.10 international dollars for the individual testing and 21.95 international dollars for the pooled testing, resulting in a savings of 12.15 international dollars per test performed (35.6% decrease). The mean unit cost per bacteriologically confirmed TB case was 249.64 international dollars for the individual testing and 162.44 international dollars for the pooled testing (34.9% decrease). Cost-minimization analysis indicates savings are directly associated with the proportion of samples that are positive. If the TB prevalence is ≥ 30%, pooled testing is not cost-effective. Pooled sputum testing can be a cost-effective strategy for diagnosis of TB, resulting in significant resource savings. This approach could increase testing capacity and affordability in resource-limited settings and support increased testing towards achievement of WHO End TB strategy.Universitat Autònoma de Barcelona 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/281277https://dx.doi.org/urn:doi:10.1186/s12879-023-08330-9reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2812772026-06-06T12:50:31Z
dc.title.none.fl_str_mv Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
a cost-effectiveness analysis
title Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
spellingShingle Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
Iem, Vibol|||0000-0001-6155-1402
Cost-effectiveness
Cost-minimization analysis
Pooling
Tuberculosis
Xpert MTB/RIF
Xpert Ultra
title_short Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
title_full Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
title_fullStr Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
title_full_unstemmed Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
title_sort Pooling sputum testing to diagnose tuberculosis using xpert MTB/RIF and xpert ultra
dc.creator.none.fl_str_mv Iem, Vibol|||0000-0001-6155-1402
Bimba, John|||0000-0001-7847-4271
Santos, Victor S.
Domínguez, José|||0000-0001-7888-0309
Creswell, Jacob|||0000-0002-4885-940X
Somphavong, Silaphet
Wingfield, Tom
Khan, Jahangir A. M.
Cuevas, Luis E..|||0000-0002-6581-0587
author Iem, Vibol|||0000-0001-6155-1402
author_facet Iem, Vibol|||0000-0001-6155-1402
Bimba, John|||0000-0001-7847-4271
Santos, Victor S.
Domínguez, José|||0000-0001-7888-0309
Creswell, Jacob|||0000-0002-4885-940X
Somphavong, Silaphet
Wingfield, Tom
Khan, Jahangir A. M.
Cuevas, Luis E..|||0000-0002-6581-0587
author_role author
author2 Bimba, John|||0000-0001-7847-4271
Santos, Victor S.
Domínguez, José|||0000-0001-7888-0309
Creswell, Jacob|||0000-0002-4885-940X
Somphavong, Silaphet
Wingfield, Tom
Khan, Jahangir A. M.
Cuevas, Luis E..|||0000-0002-6581-0587
author2_role author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Cost-effectiveness
Cost-minimization analysis
Pooling
Tuberculosis
Xpert MTB/RIF
Xpert Ultra
topic Cost-effectiveness
Cost-minimization analysis
Pooling
Tuberculosis
Xpert MTB/RIF
Xpert Ultra
description The World Health Organization (WHO) recommends the diagnosis of tuberculosis (TB) using molecular tests, such as Xpert MTB/RIF (MTB/RIF) or Xpert Ultra (Ultra). These tests are expensive and resource-consuming, and cost-effective approaches are needed for greater coverage. We evaluated the cost-effectiveness of pooling sputum samples for TB testing by using a fixed amount of 1,000 MTB/RIF or Ultra cartridges. We used the number of people with TB detected as the indicator for cost-effectiveness. Cost-minimization analysis was conducted from the healthcare system perspective and included the costs to the healthcare system using pooled and individual testing. There was no significant difference in the overall performance of the pooled testing using MTB/RIF or Ultra (sensitivity, 93.9% vs. 97.6%, specificity 98% vs. 97%, p-value > 0.1 for both). The mean unit cost across all studies to test one person was 34.10 international dollars for the individual testing and 21.95 international dollars for the pooled testing, resulting in a savings of 12.15 international dollars per test performed (35.6% decrease). The mean unit cost per bacteriologically confirmed TB case was 249.64 international dollars for the individual testing and 162.44 international dollars for the pooled testing (34.9% decrease). Cost-minimization analysis indicates savings are directly associated with the proportion of samples that are positive. If the TB prevalence is ≥ 30%, pooled testing is not cost-effective. Pooled sputum testing can be a cost-effective strategy for diagnosis of TB, resulting in significant resource savings. This approach could increase testing capacity and affordability in resource-limited settings and support increased testing towards achievement of WHO End TB strategy.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/281277
https://dx.doi.org/urn:doi:10.1186/s12879-023-08330-9
url https://ddd.uab.cat/record/281277
https://dx.doi.org/urn:doi:10.1186/s12879-023-08330-9
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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