Format

Send to

Choose Destination
See comment in PubMed Commons below
Elife. 2014 Jun 4;3. doi: 10.7554/eLife.02565.

A user-friendly, open-source tool to project impact and cost of diagnostic tests for tuberculosis.

Author information

1
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.
2
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, United States.
3
School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.
4
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States.

Abstract

Most models of infectious diseases, including tuberculosis (TB), do not provide results customized to local conditions. We created a dynamic transmission model to project TB incidence, TB mortality, multidrug-resistant (MDR) TB prevalence, and incremental costs over 5 years after scale-up of nine alternative diagnostic strategies. A corresponding web-based interface allows users to specify local costs and epidemiology. In settings with little capacity for up-front investment, same-day microscopy had the greatest impact on TB incidence and became cost-saving within 5 years if delivered at $10/test. With greater initial investment, population-level scale-up of Xpert MTB/RIF or microcolony-based culture often averted 10 times more TB cases than narrowly-targeted strategies, at minimal incremental long-term cost. Xpert for smear-positive TB had reasonable impact on MDR-TB incidence, but at substantial price and little impact on overall TB incidence and mortality. This user-friendly modeling framework improves decision-makers' ability to evaluate the local impact of TB diagnostic strategies.

KEYWORDS:

diagnostic techniques and procedures; economic models; epidemiology; global health; infectious disease transmission; none; tuberculosis

PMID:
24898755
PMCID:
PMC4082287
DOI:
10.7554/eLife.02565
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for eLife Sciences Publications, Ltd Icon for PubMed Central
    Loading ...
    Support Center