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Cost-Effectiveness of Currently Available Diagnostic Tools for Diagnosis of Pediatric Tuberculosis Under National

Ragini Bhatia1, Anil Chauhan2, Kulbir Kaur1

  • 1Department of Pediatrics, PGIMER, Chandigarh, India.

Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine
|April 21, 2023
PubMed

Insights

TrueNat is a more cost-effective diagnostic tool for pediatric tuberculosis (TB) in India than GeneXpert. This approach averts more disability-adjusted life years (DALYs), offering significant health benefits for children.

Area of Science:

  • Medical Diagnostics
  • Public Health
  • Health Economics

Background:

  • Pediatric tuberculosis (TB) diagnosis in India faces challenges including limited screening, inadequate samples, and low detection rates.
  • Effective and cost-efficient diagnostic strategies are crucial for improving child health outcomes in TB-endemic regions.

Purpose of the Study:

  • To evaluate the cost-effectiveness of different diagnostic modalities for pediatric TB in India.
  • To compare TrueNat MTB with GeneXpert MTB and sputum microscopy for diagnosing TB in children under 15.

Main Methods:

  • A decision tree model was used to simulate a cohort of children undergoing TB diagnosis.
  • Costs, effectiveness (measured in disability-adjusted life years - DALYs averted), and cost-effectiveness ratios were calculated for each diagnostic intervention.
  • Evidence on test performance and costs was systematically researched.

Main Results:

  • TrueNat demonstrated a lower cost per DALY averted (Rs. 9450) compared to GeneXpert MTB/RIF (Rs. 9750).
  • The incremental cost-effectiveness ratio for TrueNat versus GeneXpert was Rs. 5925 per DALY averted.
  • TrueNat point-of-care diagnosis is projected to avert 962 more DALYs than GeneXpert.

Conclusions:

  • TrueNat is a more cost-effective diagnostic intervention for pediatric TB in India, significantly reducing disability.
  • The cost-effectiveness of TrueNat is favorable, falling below India's GDP per capita, indicating substantial health benefits.
  • Implementing TrueNat can lead to considerable improvements in averting DALYs for children with TB.

Keywords:
ChildrenGeneXpert MTBTrueNat MTBtuberculosis

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