{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T04:22:35Z","timestamp":1773807755550,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"Suppl 1","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100032626","name":"Unitaid","doi-asserted-by":"crossref","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}],"id":[{"id":"10.13039\/100032626","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,8,15]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Understanding costs associated with identification of emerging infections is critical to inform the policy. Nested within a randomised controlled trial that found that a test-all (TA) model for rapid SARS-CoV-2 testing identified more SARS-CoV-2 cases than the standard screen-and-test (ST) model. Our study assessed the cost-effectiveness of integrating SARS-CoV-2 services into maternal, neonatal and child health (MNCH), HIV and tuberculosis (TB) clinics using the two models in Cameroon and Kenya.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The total costs of implementing the TA and ST models in Cameroon and Kenya were estimated from a health systems perspective using a micro-costing method. The cost per client tested (CPCT) and tested positive (CPCTP) for SARS-CoV-2 were estimated by dividing the total cost of each model by the number of clients tested and tested positive, respectively. A decision tree and cost-effectiveness acceptability curve were used to compare the cost-effectiveness of the two models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Cameroon, the total cost of the TA model was US$141,942, while the ST model was US$48,020. In the TA model, the CPCT was US$7.66 and the CPCTP was US$508.75, whereas in the ST model, they were US$25.02 and US$727.58, respectively. In the TA model, the biggest cost was SARS-CoV-2 antigen rapid detection tests (Ag-RDTs) at 61% (US$86,853), whereas in the ST model, it was personnel at 39% (US$18,592). In Kenya, the total cost was US$39,264 in the TA model and US$27,500 in the ST model. The TA CPCT was US$13.04 and the CPCTP was US$1,189.81, whereas in the ST model the costs were $125.00 and $1,250.01 respectively. In both models in Kenya, the biggest expenditure was personnel, at 45% ($17,696) of cost in TA and 56% ($15,267) in ST. In both countries, the TA model was more cost-effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of the TA model is a more cost-effective approach to increase early identification of individuals with SARS-CoV-2 infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001021","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T10:15:29Z","timestamp":1760523329000},"page":"e001021","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Micro-costing analysis of integrating SARS-CoV-2 antigen rapid detection tests into routine health facility services: a comparison of test-all versus screen-and-test models in Cameroon and Kenya"],"prefix":"10.1136","volume":"2","clinical-trial-number":[{"clinical-trial-number":"nct05382130","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-494X","authenticated-orcid":false,"given":"Mario","family":"Songane","sequence":"first","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8747-9610","authenticated-orcid":false,"given":"Boris","family":"Tchounga","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Yaound\u00e9, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1801-7938","authenticated-orcid":false,"given":"Rose Otieno","family":"Masaba","sequence":"additional","affiliation":[{"name":"Research, Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9634-8532","authenticated-orcid":false,"given":"Tatiana Katcho","family":"Djikeusi","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Yaound\u00e9, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Ndimbii","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Nairobi, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolyn","family":"Mwancha-Kwasa","sequence":"additional","affiliation":[{"name":"Kiambu County Health Research and Development Unit, Kiambu, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilienne","family":"Epee","sequence":"additional","affiliation":[{"name":"Division of Disease, Epidemic and Pandemic Control, Ministry of Public Health, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Cecile","family":"Zoung-Kanyi Bissek","sequence":"additional","affiliation":[{"name":"Operational Research in Health Department, Ministry of Public Health, Yaounde, Cameroon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aida","family":"Yemaneberhan","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Guay","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"},{"name":"George Washington University Milken Institute School of Public Health, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhoderick","family":"Machekano","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8389-7786","authenticated-orcid":false,"given":"Nilesh","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Appolinaire","family":"Tiam","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushant","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Elizabeth Glaser Pediatric AIDS Foundation, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"2025122304350664000_2.Suppl_1.e001021.1","unstructured":"WHO . 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