The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
-
Int. J. Tuberc. Lung Dis. · Apr 2013
Multicenter StudyCost utility of lateral-flow urine lipoarabinomannan for tuberculosis diagnosis in HIV-infected African adults.
In-patient hospitals in South Africa and Uganda. ⋯ For every 1000 patients tested, adding lateral-flow urine LAM generated 80 incremental appropriate anti-tuberculosis treatments and averted 224 DALYs. Estimated cost utility was US$353 per DALY averted (95% uncertainty range $192$1161) in South Africa and $86 per DALY averted (95% uncertainty range $49$239) in Uganda, reflecting the lower treatment costs in Uganda. Cost utility was most sensitive to assay specificity, cost of anti-tuberculosis treatment, life expectancy after TB cure and cohort TB prevalence, but did not rise above $1500 per DALY averted in South Africa under any one-way sensitivity analysis. The probability of acceptability was >99.8% at a per-DALY willingness-to-pay threshold equal to the per capita gross domestic product in South Africa ($7275) and Uganda ($509).