Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa
OBJECTIVE: To measure the costs and estimate the cost-effectiveness of the ProTEST package of tuberculosis/human immunodeficiency virus (TB/HIV) interventions in primary health care facilities in Cape Town, South Africa. METHODS: We collected annual cost data retrospectively using ingredients-based...
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| Format: | Article |
| Language: | English |
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The World Health Organization
2006-07-01
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| Series: | Bulletin of the World Health Organization |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700014&lng=en&tlng=en |
| _version_ | 1797283187425017856 |
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| author | Harry Peter Hausler Edina Sinanovic Lilani Kumaranayake Pren Naidoo Hennie Schoeman Barbara Karpakis Peter Godfrey-Faussett |
| author_facet | Harry Peter Hausler Edina Sinanovic Lilani Kumaranayake Pren Naidoo Hennie Schoeman Barbara Karpakis Peter Godfrey-Faussett |
| author_sort | Harry Peter Hausler |
| collection | DOAJ |
| description | OBJECTIVE: To measure the costs and estimate the cost-effectiveness of the ProTEST package of tuberculosis/human immunodeficiency virus (TB/HIV) interventions in primary health care facilities in Cape Town, South Africa. METHODS: We collected annual cost data retrospectively using ingredients-based costing in three primary care facilities and estimated the cost per HIV infection averted and the cost per TB case prevented. FINDINGS: The range of costs per person for the ProTEST interventions in the three facilities were: US$ 7-11 for voluntary counselling and testing (VCT), US$ 81-166 for detecting a TB case, US$ 92-183 for completing isoniazid preventive therapy (IPT) and US$ 20-44 for completing six months of cotrimoxazole preventive therapy. The estimated cost per HIV infection averted by VCT was US$ 67-112. The cost per TB case prevented by VCT (through preventing HIV) was US$ 129-215, by intensified case finding was US$ 323-664 and by IPT was US$ 486-962. Sensitivity analysis showed that the use of chest X-rays for IPT screening decreases the cost-effectiveness of IPT in preventing TB cases by 36%. IPT screening with or without tuberculin purified protein derivative screening was almost equally cost-effective. CONCLUSION: We conclude that the ProTEST package is cost saving. Despite moderate adherence, linking prevention and care interventions for TB and HIV resulted in the estimated costs of preventing TB being less than previous estimates of costs of treating it. VCT was less expensive than previously reported in Africa. |
| first_indexed | 2024-03-07T17:26:31Z |
| format | Article |
| id | doaj.art-b4c26df965534bf385885125d60cbdc5 |
| institution | Directory Open Access Journal |
| issn | 0042-9686 |
| language | English |
| last_indexed | 2024-03-07T17:26:31Z |
| publishDate | 2006-07-01 |
| publisher | The World Health Organization |
| record_format | Article |
| series | Bulletin of the World Health Organization |
| spelling | doaj.art-b4c26df965534bf385885125d60cbdc52024-03-02T18:56:16ZengThe World Health OrganizationBulletin of the World Health Organization0042-96862006-07-01847528536S0042-96862006000700014Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South AfricaHarry Peter Hausler0Edina Sinanovic1Lilani Kumaranayake2Pren Naidoo3Hennie Schoeman4Barbara Karpakis5Peter Godfrey-Faussett6University of Western CapeUniversity of Cape TownLondon School of Hygiene and Tropical MedicineCape Town AdministrationIndependent consultantCape Town AdministrationLondon School of Hygiene and Tropical MedicineOBJECTIVE: To measure the costs and estimate the cost-effectiveness of the ProTEST package of tuberculosis/human immunodeficiency virus (TB/HIV) interventions in primary health care facilities in Cape Town, South Africa. METHODS: We collected annual cost data retrospectively using ingredients-based costing in three primary care facilities and estimated the cost per HIV infection averted and the cost per TB case prevented. FINDINGS: The range of costs per person for the ProTEST interventions in the three facilities were: US$ 7-11 for voluntary counselling and testing (VCT), US$ 81-166 for detecting a TB case, US$ 92-183 for completing isoniazid preventive therapy (IPT) and US$ 20-44 for completing six months of cotrimoxazole preventive therapy. The estimated cost per HIV infection averted by VCT was US$ 67-112. The cost per TB case prevented by VCT (through preventing HIV) was US$ 129-215, by intensified case finding was US$ 323-664 and by IPT was US$ 486-962. Sensitivity analysis showed that the use of chest X-rays for IPT screening decreases the cost-effectiveness of IPT in preventing TB cases by 36%. IPT screening with or without tuberculin purified protein derivative screening was almost equally cost-effective. CONCLUSION: We conclude that the ProTEST package is cost saving. Despite moderate adherence, linking prevention and care interventions for TB and HIV resulted in the estimated costs of preventing TB being less than previous estimates of costs of treating it. VCT was less expensive than previously reported in Africa.http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700014&lng=en&tlng=en |
| spellingShingle | Harry Peter Hausler Edina Sinanovic Lilani Kumaranayake Pren Naidoo Hennie Schoeman Barbara Karpakis Peter Godfrey-Faussett Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa Bulletin of the World Health Organization |
| title | Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa |
| title_full | Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa |
| title_fullStr | Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa |
| title_full_unstemmed | Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa |
| title_short | Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa |
| title_sort | costs of measures to control tuberculosis hiv in public primary care facilities in cape town south africa |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862006000700014&lng=en&tlng=en |
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