{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T15:40:01Z","timestamp":1776699601909,"version":"3.51.2"},"reference-count":16,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,27]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extrapulmonary tuberculosis (EPTB) poses a significant diagnostic and economic challenge in HIV endemic, low-resource settings due to its complex presentation and current diagnostic tools limitations. While accurate and timely diagnosis is critical for reducing morbidity, mortality and health system costs, economic evaluations of EPTB diagnostics remain sparse and fragmented. This protocol aims to map existing evidence on the economic evaluation of diagnostic innovations for EPTB in low-resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This scoping review protocol follows the Joanna Briggs Institute (JBI) methodological framework and registered on the Open Science Framework. Peer-reviewed articles, grey literature and official reports published between 2000 and 2025 will be searched in PubMed, MEDLINE, Google Scholar, Scopus and Science Direct. The search strategy is structured using the Population, Intervention, Comparator, Outcome, Time, Study design and Setting (PICOTSS) framework, and will be peer-reviewed using the Peer Review of Electronic Search Strategies (PRESS) guideline. Study selection, data charting and extraction will be performed independently by two reviewers. Data will be charted iteratively, and the methodological quality of selected economic evaluations will be appraised using the Drummond checklist. Results will be synthesised in narrative summaries and tabular formats. Final reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) reporting guideline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>For review of previously published data, ethical approval is not required. Findings will be disseminated in professional networks, stakeholder meetings and a peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>OSF Registration DOI 10.17605\/OSF.IO\/BTCPG<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-116065","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:45:40Z","timestamp":1776696340000},"page":"e116065","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Economic evidence of health technology innovations for the diagnosis of extrapulmonary TB in resource-limited settings: a scoping review protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3152-8567","authenticated-orcid":false,"given":"Juliet G","family":"Nyamasve","sequence":"first","affiliation":[{"name":"Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, University of Cape Town Department of Medicine, Cape Town, South Africa"},{"name":"Biomedical Research and Training Institute, Harare, Harare Province, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nyaradzai A","family":"Katena","sequence":"additional","affiliation":[{"name":"Department of Global, Public Health and Family Medicine, University of Zimbabwe, Harare, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shepherd","family":"Shamu","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Harare Province, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junior","family":"Mutsvangwa","sequence":"additional","affiliation":[{"name":"Biomedical Research and Training Institute, Harare, Harare Province, Zimbabwe"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliasgar","family":"Esmail","sequence":"additional","affiliation":[{"name":"Lung Infection and Immunity Unit, Division of Pulmonology and UCT Lung Institute, University of Cape Town Department of Medicine, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"2026042007451526000_16.4.e116065.1","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2466-14-58","article-title":"Comparison of same day diagnostic tools including Gene Xpert and unstimulated IFN-\u03b3 for the evaluation of pleural tuberculosis: a prospective cohort study","volume":"14","author":"Meldau","year":"2014","journal-title":"BMC Pulm Med"},{"key":"2026042007451526000_16.4.e116065.2","unstructured":"Friedrich SO , von G-B , Diacon AH . Xpert MTB\/RIF assay for diagnosis of pleural tuberculosis - pubmed. Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/21998430\/ [Accessed 26 Oct 2026]."},{"key":"2026042007451526000_16.4.e116065.3","unstructured":"PubMed . Diagnostic performance of xpert MTB\/RIF in tuberculous pleural effusion: systematic review and meta-analysis - pubmed. Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/26818675\/ [Accessed 26 Oct 2026]."},{"key":"2026042007451526000_16.4.e116065.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.03.021"},{"key":"2026042007451526000_16.4.e116065.5","doi-asserted-by":"crossref","DOI":"10.3389\/fmicb.2022.817661","article-title":"Rapid Molecular Diagnosis of Extra-Pulmonary Tuberculosis by Xpert\/RIF Ultra","volume":"13","author":"Rindi","year":"2022","journal-title":"Front Microbiol"},{"key":"2026042007451526000_16.4.e116065.6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0251618","article-title":"Diagnostic accuracy of GeneXpert MTB\/RIF assay for detection of tubercular pleural effusion","volume":"16","author":"Jain","year":"2021","journal-title":"PLoS One"},{"key":"2026042007451526000_16.4.e116065.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0229875","article-title":"Extrapulmonary tuberculosis in HIV-infected patients in rural Tanzania: The prospective Kilombero and Ulanga antiretroviral cohort","volume":"15","author":"Arpagaus","year":"2020","journal-title":"PLoS One"},{"key":"2026042007451526000_16.4.e116065.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0254204","article-title":"Health care seeking patterns of rifampicin-resistant tuberculosis patients in Harare, Zimbabwe: A prospective cohort study","volume":"16","author":"Tadokera","year":"2021","journal-title":"PLoS One"},{"key":"2026042007451526000_16.4.e116065.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003752","article-title":"Computer-aided X-ray screening for tuberculosis and HIV testing among adults with cough in Malawi (the PROSPECT study): A randomised trial and cost-effectiveness analysis","volume":"18","author":"MacPherson","year":"2021","journal-title":"PLoS Med"},{"key":"2026042007451526000_16.4.e116065.10","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1016\/j.ijtb.2024.04.006","article-title":"A systematic review on cost-effectiveness of diagnostic methods and treatments for tuberculosis in India","volume":"72 Suppl 2","author":"Balakrishnan","year":"2025","journal-title":"Indian J Tuberc"},{"key":"2026042007451526000_16.4.e116065.11","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/QAI.0b013e318246538f","article-title":"Cost-Effectiveness of Tuberculosis Diagnostic Strategies to Reduce Early Mortality Among Persons With Advanced HIV Infection Initiating Antiretroviral Therapy","volume":"60","author":"Abimbola","year":"2012","journal-title":"JAIDS Journal of Acquired Immune Deficiency Syndromes"},{"key":"2026042007451526000_16.4.e116065.12","doi-asserted-by":"crossref","first-page":"3167","DOI":"10.21037\/jtd-22-106","article-title":"Economic evaluation of microbiological and host biomarker-based tests for the diagnosis of pleural tuberculosis in a high burden setting","volume":"14","author":"Pooran","year":"2022","journal-title":"J Thorac Dis"},{"key":"2026042007451526000_16.4.e116065.13","doi-asserted-by":"crossref","DOI":"10.2196\/15727","article-title":"Use of Digital Technology to Enhance Tuberculosis Control: Scoping Review","volume":"22","author":"Lee","year":"2020","journal-title":"J Med Internet Res"},{"key":"2026042007451526000_16.4.e116065.14","unstructured":"Lely J , Morris H , Sasson N , et al . How to write a scoping review protocol: Guidance and template. Published Online First 2023."},{"key":"2026042007451526000_16.4.e116065.15","doi-asserted-by":"crossref","unstructured":"Peters MD , Godfrey C , McInerney P , et al . Scoping reviews. 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