Patient costs for the diagnosis of tuberculosis in Brazil: comparison of XpertW MTB/RIF and smear microscopy
Patient costs for the diagnosis of tuberculosis in Brazil: comparison of XpertW MTB/RIF and smear microscopy
Data
2014
Autores
Antunes, R. da Silva
Pinto, M
Trajma, A.
Journal Title
Journal ISSN
Volume Title
Publisher
The International Journal of Tuberculosis and Lung Disease
Resumo
SETTING: Manaus and Rio de Janeiro, two Brazilian
state capitals with the country’s fifth and sixth highest
tuberculosis (TB) incidence rates (around 90/100 000
population in 2012).
OBJECTIVE: To compare the costs of the Xpertw MTB/
RIF assay with those of standard care (two smears) in
diagnosing TB from the patient’s perspective.
METHOD: We interviewed 218 patients diagnosed with
TB in the previous 4 months by Xpert or smear
microscopy. Information on non-medical direct costs
for transportation and food, indirect costs such as time
spent for diagnostic visits and socio-demographic data
were gathered.
RESULTS: The median patient income was US$390.24.
Median total costs incurred by patients were 54% higher
with the smear process than with Xpert (US$25.24 vs.
US$16.44, P , 0.000) due to higher indirect and direct
costs. Male patients incurred higher indirect costs
(U$10.27 vs. US$7.51, P 1⁄4 0.038), and patients in
Manaus incurred higher total costs.
CONCLUSIONS: Although the diagnosis and treatment
of TB in Brazil are free of charge, non-medical direct and
indirect costs for patients may represent important
barriers to accessing appropriate care. Compared to
standard care, Xpert reduced the financial burden for
patients. These findings support the decision to scale-up
Xpert technology in the country.
Description
Palavras-chave
costs, diagnosis, real-time polymerase chain reaction, sputum smear, tuberculosis
Citação
Antunes RS, Pinto M, Trajman A. Patient costs for the diagnosis of tuberculosis in Brazil: comparison of Xpert MTB/RIF and smear microscopy. Int J Tuberc Lung Dis. 2014 May;18(5):547-51. doi: 10.5588/ijtld.13.0637