Comparison of laboratory costs of rapid molecular tests and conventional diagnostics for detection of tuberculosis and drug-resistant tuberculosis in South Africa
Abstract 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 MTBDR plus 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 MTBDR plus) for …
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 MTBDR plus 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 MTBDR plus) for …
Abstract
Abstract 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 MTBDR plus 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 MTBDR plus) 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/sampleandtheMTBDRpluslineprobeassaycost 23.46/sample, compared to 16.88/sampleusingconventionalautomatedliquidculture-basedmethods.LaboratorycostsofXpertandMTBDRplusweremostinfluencedbycostofconsumables(60-80%).ConclusionsAtcurrentpublicsectorpricing,XpertMTB/RIFandMTBDRplusarecomparableincosttomycobacterialcultureandconventionaldrugsensitivitytesting.Overall,referencelaboratoriesmustbalancecostswithperformancecharacteristicsandtheneedforrapidresults.
Springer