{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:37:09Z","timestamp":1761129429945},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T00:00:00Z","timestamp":1493683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2017,6]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To compare the cost\u2013utility of microscopic observation drug\u2010susceptibility assay (MODS<\/jats:styled-content>) and Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> implementation for tuberculosis (TB<\/jats:styled-content>) diagnosis in rural northern Mozambique.<\/jats:p><\/jats:sec>Methods<\/jats:title>Stochastic transmission compartmental TB<\/jats:styled-content> model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS<\/jats:styled-content> and Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> were evaluated as replacement test of smear microscopy (SM<\/jats:styled-content>) or as an add\u2010on test after a negative SM<\/jats:styled-content>. Costs were calculated in 2013 USD<\/jats:styled-content>, effects in disability\u2010adjusted life years (DALY<\/jats:styled-content>). Willingness to pay threshold (WPT<\/jats:styled-content>) was established at once the per capita Gross National Income of Mozambique.<\/jats:p><\/jats:sec>Results<\/jats:title>MODS<\/jats:styled-content> as an add\u2010on test to negative SM<\/jats:styled-content> produced an incremental cost\u2010effectiveness ratio (ICER<\/jats:styled-content>) of 5647.89USD<\/jats:styled-content>\/DALY<\/jats:styled-content> averted. MODS<\/jats:styled-content> as a substitute for SM<\/jats:styled-content> yielded an ICER<\/jats:styled-content> of 5374.58USD<\/jats:styled-content>\/DALY<\/jats:styled-content> averted. Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> as an add\u2010on test to negative SM<\/jats:styled-content> yielded ICER<\/jats:styled-content> of 345.71USD<\/jats:styled-content>\/DALY<\/jats:styled-content> averted. Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> as a substitute for SM<\/jats:styled-content> obtained an ICER<\/jats:styled-content> of 122.13USD<\/jats:styled-content>\/DALY<\/jats:styled-content> averted. TB<\/jats:styled-content> prevalence and risk of infection were the main factors impacting MODS<\/jats:styled-content> and Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF ICER<\/jats:styled-content> in the one\u2010way sensitivity analysis. In the probabilistic sensitivity analysis, Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> was most likely to have an ICER<\/jats:styled-content> below the WPT<\/jats:styled-content>, whereas MODS<\/jats:styled-content> was not.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our cost\u2013utility analysis favours the implementation of Xpert\u00ae<\/jats:sup> MTB<\/jats:styled-content>\/RIF<\/jats:styled-content> as a replacement of SM<\/jats:styled-content> for all TB<\/jats:styled-content> suspects in this rural high TB<\/jats:styled-content>\/HIV<\/jats:styled-content> prevalence African setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12879","type":"journal-article","created":{"date-parts":[[2017,4,5]],"date-time":"2017-04-05T22:25:29Z","timestamp":1491431129000},"page":"734-743","source":"Crossref","is-referenced-by-count":8,"title":["Microscopic observation drug\u2010susceptibility assay vs<\/i>. Xpert\u00ae<\/sup>MTB<\/scp>\/RIF<\/scp> for the diagnosis of tuberculosis in a rural African setting: a cost\u2013utility analysis"],"prefix":"10.1111","volume":"22","author":[{"given":"Philip E.","family":"Wikman\u2010Jorgensen","sequence":"first","affiliation":[{"name":"Department of Public Health University of Barcelona Barcelona Spain"},{"name":"SolidarMed Mozambique Ancuabe Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jara","family":"Llenas\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"SolidarMed Mozambique Ancuabe Mozambique"},{"name":"Infectious Diseases Unit Hospital General Universitario de Elche Alicante Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom\u00e0s M.","family":"P\u00e9rez\u2010Porcuna","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Barcelona Barcelona Spain"},{"name":"Research Unit Paediatrics Department CAP Valldoreix Mutua Terrassa Foundation Mutua Terrassa University Hospital Terrassa Catalunya Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Hobbins","sequence":"additional","affiliation":[{"name":"SolidarMed Switzerland Luzern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jochen","family":"Ehmer","sequence":"additional","affiliation":[{"name":"SolidarMed Switzerland Luzern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel A.","family":"Mussa","sequence":"additional","affiliation":[{"name":"Provincial Health Directorate Operational Research Nucleus of Pemba Pemba Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Ascaso","sequence":"additional","affiliation":[{"name":"Department of Public Health University of Barcelona Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,2]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"WHO.Global Tuberculosis Report 2015[Internet]. 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