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对于结核病药物敏感性测试中等复杂性NAAT的成本和安置决策的确定
Akash Malhotra1, Ryan Thompson1, Margaretha De Vos2
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
PloS one
|August 24, 2023
概括
对耐药结核病的检测至关重要. 中等复杂度的核酸放大测试 (MC-NAAT) 提供了更好的药物敏感性测试 (DST) 覆盖范围,更高的吞吐量选项通常更具成本效益.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 公共卫生 公共卫生
- 分子生物学分子生物学
背景情况:
- 在高负担国家,获得耐药结核病检测仍然是一个重大挑战.
- 世界卫生组织已经批准了中等复杂度的核酸放大测试 (MC-NAATs),以提高药物敏感性测试 (DST) 的覆盖率.
研究的目的:
- 对两个具有不同吞吐量 (低吞吐量和高吞吐量) 的MC-NAAT进行成本分析,以便在资源有限的环境中实施.
- 确定不同MC-NAAT系统的关键成本驱动因素和最佳测试量.
主要方法:
- 对低吞吐量 (<24次/运行) 和高吞吐量 (高达90次/运行) 的MC-NAAT进行比较性成本分析.
- 根据测试频率,设备费用和工作量等运营因素评估每次测试成本.
主要成果:
- 基准案例每次测试的成本为LT的18.52美元和HT MC-NAAT的15.37美元.
- 成本灵敏度分析显示,测试频率,设备成本和结核病工作量显著影响每次测试费用.
- 高吞吐量 (HT) 的MC-NAAT在所有体积上通常更具成本效益,尽管如果设备成本或系统耐用性明显更好,在2000次/年以下的体积上,LT可能会更便宜.
结论:
- 对于MC-NAAT的安置策略,应优先考虑实验室的操作因素,测试需求和成本效益.
- 优化MC-NAAT的使用对于改善资源有限的环境中DST覆盖率至关重要.
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