基于决策分析建模的尼日利亚不同结核病诊断方法的成本效益
Hafsat U Ibrahim1,2, Rayyan M Garba3,4, Jameel I Ahmad5,6
1Paediatrics, Aminu Kano Teaching Hospital, Kano, Nigeria ibrahimhafsat@ymail.com.
BMJ global health
|August 5, 2025
概括
对于尼日利亚艾滋病毒感染者来说,结核酸脂原比诺 (TB-LAM) 检测是诊断结核病 (TB) 的最经济有效的方法. 这种诊断策略在资源有限的环境中具有显著价值.
科学领域:
- 全球健康 全球健康
- 传染病流行病学 传染病流行病学
- 卫生经济学 卫生经济学
背景情况:
- 结核病 (TB) 是尼日利亚的一个主要的健康问题,特别是在艾滋病毒感染者 (PLWH) 中.
- 传统的结核病诊断在PLWH中往往是不准确的,原因是涂抹阴性结果和非典型的放射性发现.
- 像Xpert MTB/RIF Ultra,TB-LAM和TB-LAMP这样的最新测试显示出有希望的结果,但它们在尼日利亚的成本效益是未知的.
研究的目的:
- 对尼日利亚的PLWH结核病诊断算法进行经济评估.
- 为了比较Xpert MTB/RIF Ultra,TB-LAM和TB-LAMP的成本效益,每个都是在胸部X射线图之后进行的.
主要方法:
- 使用决策树模型与成本效益分析相结合.
- 关于测试准确性,成本和结核病患病率的数据来源于系统性审查和元分析.
- 计算了增量成本效益比率 (ICER),并进行了敏感性分析.
主要成果:
- 结核病-LAM算法是最具成本效益的,每例检测结核病的成本为17美元.
- 而Xpert MTB/RIF Ultra和TB-LAMP的成本更高,分别为20美元和22美元.
- 结果在各种参数输入中保持强,并且与支付意愿值一致.
结论:
- 结核病-LAM算法是尼日利亚PLWH最具成本效益的结核病诊断策略.
- 在有足够的基础设施和资金的环境中,Xpert MTB/RIF Ultra可能是有价值的.
- 量身定制的诊断方法,平衡准确性,可扩展性和可负担性,对于改善弱势群体的结核病检测至关重要.
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