L. Mwenge - Academia.edu (original) (raw)

Papers by L. Mwenge

The Lancet Global Health, 2021

Contemporary Clinical Trials, 2021

Clinical Infectious Diseases, 2019

Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing C... more Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) trial, 2 weeks of fluconazole (FLU) plus flucytosine (5FC) was as effective and less costly than 2 weeks of amphotericin-based regimens. However, many African settings treat with FLU monotherapy, and the cost-effectiveness of adding 5FC to FLU is uncertain. Methods The effectiveness and costs of FLU+5FC were taken from ACTA, which included a costing analysis at the Zambian site. The effectiveness of FLU was derived from cohorts of consecutively enrolled patients, managed in respects other than drug therapy, as were participants in ACTA. FLU costs were derived from costs of FLU+5FC in ACTA, by subtracting 5FC drug and monitoring costs. The cost-effectiveness of FLU+5FC vs FLU alone was measured as the incremental cost-effectiveness ratio (ICER). A probabilistic sensitivity analysis assessed uncertainties and a bivariate deterministic sens...

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB... more Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. A cross-sectional survey of 103 adult TB patients who had been on treatment for 1-3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56-40.30) per patient--equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were significant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs inc...

Fertility and Sterility, 2001

Cost Effectiveness and Resource Allocation, 2014

Introduction HIV self-testing (HIVST) is a new approach to HIV testing where a person collects hi... more Introduction HIV self-testing (HIVST) is a new approach to HIV testing where a person collects his or her own specimen, performs an HIV test and interprets the result, either alone or with someone he or she trusts. It is becoming increasingly relevant as a complement to standard-of-care HIV testing and is now recommended by the World Health Organization. Few studies have explored user preferences around HIVST service delivery and optimal models for increasing uptake and linkage to care, particularly among hard-to-reach populations. This paper describes an ongoing study that uses discrete choice experiments (DCE) to identify key HIVST service characteristics that drive people’s willingness to self-test for HIV and link to care, measure the relative strength of user preferences, and explore preference heterogeneity in Southern Africa. Method and Analysis Two DCEs – one on HIVST delivery and one on linkage to care after a positive self-test – are being administered in Malawi, Zambia an...

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

SETTING The expansion of culture has been proposed to aid tuberculosis (TB) control in developing... more SETTING The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. OBJECTIVES To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). DESIGN Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. RESULTS All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacterium tuberculosis specimen detected were respectively US32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum throughput, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identified M. tuberculosis would be US$4...

Background: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibo... more Background: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibody assays, Determine W HIV-1/2 (Inverness Medical) and if positive then Uni-Gold TM Recombigen HIV-1/2 (Trinity Biotech). Little is known about the performance of oral fluid based HIV testing in Zambia. The aims of this study are twofold: 1) to compare the diagnostic accuracy (sensitivity and specificity) under field conditions of the OraQuick W ADVANCE W Rapid HIV-1/2 (OraSure Technologies, Inc.) to two blood-based rapid antibody tests currently in use in the Zambia National Algorithm, and 2) to perform a cost analysis of large-scale field testing employing the OraQuick W. Methods: This was a operational retrospective research of HIV testing and questionnaire data collected in 2010 as part of the ZAMSTAR (Zambia South Africa TB and AIDS reduction) study. Randomly sampled individuals in twelve communities were tested consecutively with OraQuick W test using oral fluid versus two blood-based rapid HIV tests, Determine W and Uni-Gold TM. A cost analysis of four algorithms from health systems perspective were performed: 1) Determine W and if positive, then Uni-Gold TM (Determine W /Uni-Gold TM); based on current algorithm, 2) Determine W and if positive, then OraQuick W (Determine W /OraQuick W), 3) OraQuick W and if positive, then Determine W (OraQuick W /Determine W), 4) OraQuick W and if positive, then Uni-Gold TM (OraQuick W /Uni-Gold TM). This information was then used to construct a model using a hypothetical population of 5,000 persons with varying prevalence of HIV infection from 1–30%.

S E T T I N G : The expansion of culture has been proposed to aid tuberculosis (TB) control in de... more S E T T I N G : The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. O B J E C T I V E S : To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). D E S I G N : Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. R E S U LT S : All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacte−riumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacte-rium tuberculosis specimen detected were respectively US32).CostsperMycobacte−riumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthrough−put,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum through-put, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthrough−put,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identifi ed M. tuberculosis would be US$487 for MMGIT and higher for other methods. C O N C L U S I O N : Based on cost-effectiveness grounds, liquid media compare well with conventional solid media, especially where yield of MGIT is substantially higher than that of LJ media. The results indicate high overall costs per culture; the expansion of culture to decentral-ised levels with lower throughputs may result in even higher costs. K E Y W O R D

Objective: To estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia... more Objective: To estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia correction in Zambia. Methods: Primary data on costs and health related quality of life were collected in a prospective cohort study of 170 cataract and 113 refractive error/presbyopia patients recruited from three health facilities. Six months later, follow-up data were available from 77 and 41 patients who had received cataract surgery and spectacles, respectively. Costs were determined from patient interviews and micro-costing at the three health facilities. Utility values were gathered by administering the EQ-5D quality of life instrument immediately before and six months after cataract surgery or acquiring spectacles. A probabilistic state-transition model was used to generate cost-effectiveness estimates with uncertainty ranges. Results: Utility values significantly improved across the patient sample after cataract surgery and acquiring spectacles. Incremental costs per Quality Adjusted Life Years gained were US$ 259 for cataract surgery and US$ 375 for refractive error correction. The probabilities of the incremental cost-effectiveness ratios being below the Zambian gross national income per capita were 95% for both cataract surgery and refractive error correction. Conclusion: In spite of proven cost-effectiveness, severe health system constraints are likely to hamper scaling up of the interventions.

O B J E C T I V E S : 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment ... more O B J E C T I V E S : 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. M E T H O D S : A cross-sectional survey of 103 adult TB patients who had been on treatment for 1–3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/ care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. R E S U LT S : The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56– 40.30) per patient—equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were signifi cant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs incurred by patients on the clinic-based directly observed treatment strategy were more than three times greater than those incurred by patients on the self-administered treatment strategy (P < 0.001). C O N C L U S I O N : Clinic-based treatment supervision posed a signifi cant economic burden on patients. The creation or strengthening of community-based treatment supervision programmes would have the greatest potential impact on reducing patients' TB-related costs. K E Y W O R D

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countri... more The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacterium tuberculosis specimen detected were respectively US32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum throughput, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identified M. tuberculosis would be US$487 for MMGIT and higher for other ...

Journal of Clinical Microbiology, 2010

The performance and cost of the Capilia TB assay were evaluated for use in a resource-limited set... more The performance and cost of the Capilia TB assay were evaluated for use in a resource-limited setting. The sensitivity and specificity were 99.6% and 99.5%, respectively. The incremental costs of the Capilia test were estimated to be 1.46and1.46 and 1.46and1.84 when the test was added to liquid and solid culture processes, respectively. These findings suggest that the Capilia TB assay represents a rapid, simple, and inexpensive Mycobacterium tuberculosis identification test that can be used in resource-limited settings.

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB... more Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. A cross-sectional survey of 103 adult TB patients who had been on treatment for 1-3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56-40.30) per patient--equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were significant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs inc...

The Lancet Global Health, 2021

Contemporary Clinical Trials, 2021

Clinical Infectious Diseases, 2019

Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing C... more Background Mortality from cryptococcal meningitis remains very high in Africa. In the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) trial, 2 weeks of fluconazole (FLU) plus flucytosine (5FC) was as effective and less costly than 2 weeks of amphotericin-based regimens. However, many African settings treat with FLU monotherapy, and the cost-effectiveness of adding 5FC to FLU is uncertain. Methods The effectiveness and costs of FLU+5FC were taken from ACTA, which included a costing analysis at the Zambian site. The effectiveness of FLU was derived from cohorts of consecutively enrolled patients, managed in respects other than drug therapy, as were participants in ACTA. FLU costs were derived from costs of FLU+5FC in ACTA, by subtracting 5FC drug and monitoring costs. The cost-effectiveness of FLU+5FC vs FLU alone was measured as the incremental cost-effectiveness ratio (ICER). A probabilistic sensitivity analysis assessed uncertainties and a bivariate deterministic sens...

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB... more Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. A cross-sectional survey of 103 adult TB patients who had been on treatment for 1-3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56-40.30) per patient--equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were significant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs inc...

Fertility and Sterility, 2001

Cost Effectiveness and Resource Allocation, 2014

Introduction HIV self-testing (HIVST) is a new approach to HIV testing where a person collects hi... more Introduction HIV self-testing (HIVST) is a new approach to HIV testing where a person collects his or her own specimen, performs an HIV test and interprets the result, either alone or with someone he or she trusts. It is becoming increasingly relevant as a complement to standard-of-care HIV testing and is now recommended by the World Health Organization. Few studies have explored user preferences around HIVST service delivery and optimal models for increasing uptake and linkage to care, particularly among hard-to-reach populations. This paper describes an ongoing study that uses discrete choice experiments (DCE) to identify key HIVST service characteristics that drive people’s willingness to self-test for HIV and link to care, measure the relative strength of user preferences, and explore preference heterogeneity in Southern Africa. Method and Analysis Two DCEs – one on HIVST delivery and one on linkage to care after a positive self-test – are being administered in Malawi, Zambia an...

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

SETTING The expansion of culture has been proposed to aid tuberculosis (TB) control in developing... more SETTING The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. OBJECTIVES To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). DESIGN Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. RESULTS All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacterium tuberculosis specimen detected were respectively US32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum throughput, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identified M. tuberculosis would be US$4...

Background: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibo... more Background: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibody assays, Determine W HIV-1/2 (Inverness Medical) and if positive then Uni-Gold TM Recombigen HIV-1/2 (Trinity Biotech). Little is known about the performance of oral fluid based HIV testing in Zambia. The aims of this study are twofold: 1) to compare the diagnostic accuracy (sensitivity and specificity) under field conditions of the OraQuick W ADVANCE W Rapid HIV-1/2 (OraSure Technologies, Inc.) to two blood-based rapid antibody tests currently in use in the Zambia National Algorithm, and 2) to perform a cost analysis of large-scale field testing employing the OraQuick W. Methods: This was a operational retrospective research of HIV testing and questionnaire data collected in 2010 as part of the ZAMSTAR (Zambia South Africa TB and AIDS reduction) study. Randomly sampled individuals in twelve communities were tested consecutively with OraQuick W test using oral fluid versus two blood-based rapid HIV tests, Determine W and Uni-Gold TM. A cost analysis of four algorithms from health systems perspective were performed: 1) Determine W and if positive, then Uni-Gold TM (Determine W /Uni-Gold TM); based on current algorithm, 2) Determine W and if positive, then OraQuick W (Determine W /OraQuick W), 3) OraQuick W and if positive, then Determine W (OraQuick W /Determine W), 4) OraQuick W and if positive, then Uni-Gold TM (OraQuick W /Uni-Gold TM). This information was then used to construct a model using a hypothetical population of 5,000 persons with varying prevalence of HIV infection from 1–30%.

S E T T I N G : The expansion of culture has been proposed to aid tuberculosis (TB) control in de... more S E T T I N G : The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. O B J E C T I V E S : To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). D E S I G N : Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. R E S U LT S : All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacte−riumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacte-rium tuberculosis specimen detected were respectively US32).CostsperMycobacte−riumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthrough−put,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum through-put, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthrough−put,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identifi ed M. tuberculosis would be US$487 for MMGIT and higher for other methods. C O N C L U S I O N : Based on cost-effectiveness grounds, liquid media compare well with conventional solid media, especially where yield of MGIT is substantially higher than that of LJ media. The results indicate high overall costs per culture; the expansion of culture to decentral-ised levels with lower throughputs may result in even higher costs. K E Y W O R D

Objective: To estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia... more Objective: To estimate the cost-effectiveness of cataract surgery and refractive error/presbyopia correction in Zambia. Methods: Primary data on costs and health related quality of life were collected in a prospective cohort study of 170 cataract and 113 refractive error/presbyopia patients recruited from three health facilities. Six months later, follow-up data were available from 77 and 41 patients who had received cataract surgery and spectacles, respectively. Costs were determined from patient interviews and micro-costing at the three health facilities. Utility values were gathered by administering the EQ-5D quality of life instrument immediately before and six months after cataract surgery or acquiring spectacles. A probabilistic state-transition model was used to generate cost-effectiveness estimates with uncertainty ranges. Results: Utility values significantly improved across the patient sample after cataract surgery and acquiring spectacles. Incremental costs per Quality Adjusted Life Years gained were US$ 259 for cataract surgery and US$ 375 for refractive error correction. The probabilities of the incremental cost-effectiveness ratios being below the Zambian gross national income per capita were 95% for both cataract surgery and refractive error correction. Conclusion: In spite of proven cost-effectiveness, severe health system constraints are likely to hamper scaling up of the interventions.

O B J E C T I V E S : 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment ... more O B J E C T I V E S : 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. M E T H O D S : A cross-sectional survey of 103 adult TB patients who had been on treatment for 1–3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/ care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. R E S U LT S : The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56– 40.30) per patient—equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were signifi cant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs incurred by patients on the clinic-based directly observed treatment strategy were more than three times greater than those incurred by patients on the self-administered treatment strategy (P < 0.001). C O N C L U S I O N : Clinic-based treatment supervision posed a signifi cant economic burden on patients. The creation or strengthening of community-based treatment supervision programmes would have the greatest potential impact on reducing patients' TB-related costs. K E Y W O R D

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countri... more The expansion of culture has been proposed to aid tuberculosis (TB) control in developing countries. To examine the cost and cost-effectiveness at the Zambian National TB Reference Laboratory of homemade and commercially produced Löwenstein-Jensen culture (HLJ and CLJ) as well as automated and manually read liquid culture (AMGIT and MMGIT). Costs were estimated from the provider's perspective and based on the average monthly throughput. Cost-effectiveness estimates were based on yield during the study period. All techniques show comparable costs per culture (between US$28 and 32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS32). Costs per Mycobacterium tuberculosis specimen detected were respectively US32).CostsperMycobacteriumtuberculosisspecimendetectedwererespectivelyUS197, 202,202, 202,312 and 340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS340 for MMGIT, AMGIT, CLJ and HLJ. When modelled for the maximum throughput, costs were above US340forMMGIT,AMGIT,CLJandHLJ.Whenmodelledforthemaximumthroughput,costswereaboveUS95 per M. tuberculosis specimen detected for all techniques. When only performed among smear-negative specimens, costs per additionally identified M. tuberculosis would be US$487 for MMGIT and higher for other ...

Journal of Clinical Microbiology, 2010

The performance and cost of the Capilia TB assay were evaluated for use in a resource-limited set... more The performance and cost of the Capilia TB assay were evaluated for use in a resource-limited setting. The sensitivity and specificity were 99.6% and 99.5%, respectively. The incremental costs of the Capilia test were estimated to be 1.46and1.46 and 1.46and1.84 when the test was added to liquid and solid culture processes, respectively. These findings suggest that the Capilia TB assay represents a rapid, simple, and inexpensive Mycobacterium tuberculosis identification test that can be used in resource-limited settings.

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2008

Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB... more Urban primary health centres in Lusaka, Zambia. 1) To estimate patient costs for tuberculosis (TB) diagnosis and treatment and 2) to identify determinants of patient costs. A cross-sectional survey of 103 adult TB patients who had been on treatment for 1-3 months was conducted using a standardised questionnaire. Direct and indirect costs were estimated, converted into US$ and categorised into two time periods: 'pre-diagnosis/care-seeking' and 'post-diagnosis/treatment'. Determinants of patient costs were analysed using multiple linear regression. The median total patient costs for diagnosis and 2 months of treatment was $24.78 (interquartile range 13.56-40.30) per patient--equivalent to 47.8% of patients' median monthly income. Sex, patient delays in seeking care and method of treatment supervision were significant predictors of total patient costs. The total direct costs as a proportion of income were higher for women than men (P < 0.001). Treatment costs inc...