Comparison of laboratory costs of rapid molecular tests and conventional diagnostics for detection of tuberculosis and drug-resistant tuberculosis in South Africa

BMC Infectious Diseases

Susan E Dorman³  Gavin Churchyard¹  Gerrit Coetzee²  Violet Chihota⁴  Maunank Shah³ 

[1] School of Public Health, University of Witwatersrand, Johannesburg, South Africa;National Health Laboratory Services, Johannesburg, South Africa;Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Disease, 1503 East Jefferson St, Room 118, Baltimore, MD 21231, USA;The Aurum Institute for Health Research, Johannesburg, South Africa

关键词: Diagnostics;    Tuberculosis;    Costs;    Laboratory;   

Others  :  1146632
DOI  :  10.1186/1471-2334-13-352

 received in 2013-02-08, accepted in 2013-07-25,  发布年份 2013

【 摘 要 】

Background

The World Health Organization has endorsed the use of molecular methods for the detection of TB and drug-resistant TB as a rapid alternative to culture-based systems. In South Africa, the Xpert MTB/Rif assay and the GenoType MTBDRplus have been implemented into reference laboratories for diagnosis of TB and drug-resistance, but their costs have not been fully elucidated.

Methods

We conducted a detailed reference laboratory cost analysis of new rapid molecular assays (Xpert and MTBDRplus) for tuberculosis testing and drug-resistance testing in South Africa, and compared with the costs of conventional approaches involving sputum microscopy, liquid mycobacterial culture, and phenotypic drug sensitivity testing.

Results

From a laboratory perspective, Xpert MTB/RIF cost $14.93/sample and the MTBDRplus line probe assay cost $23.46/sample, compared to $16.88/sample using conventional automated liquid culture-based methods. Laboratory costs of Xpert and MTBDRplus were most influenced by cost of consumables (60-80%).

Conclusions

At current public sector pricing, Xpert MTB/RIF and MTBDRplus are comparable in cost to mycobacterial culture and conventional drug sensitivity testing. Overall, reference laboratories must balance costs with performance characteristics and the need for rapid results.

【 授权许可】

   
2013 Shah et al.; licensee BioMed Central Ltd.

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