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Table 2 Unit costs. For normal distributions, the first figure gives the mean and the second the variance. For uniform distributions, the two figures give the lower and upper limits.

From: Cost, affordability and cost-effectiveness of strategies to control tuberculosis in countries with high HIV prevalence

Cost item Unit Unit Cost (2003 US$) Uncertainty Distribution Reference/assumptions
TB diagnosis costs, existing level of case detection Sputum smear positive case detected 101 Normal (101, 25) Nganda et al [11]. For every sputum smear positive case detected, assume 10 TB suspects are seen. For each TB suspect, assume 3 sputum smears and 1 chest X-ray are done, in line with WHO guidelines.
TB diagnosis when case detection rate increased to 70% Sputum smear positive case detected 303 Uniform (202, 404) Recent financial data from Kenya's applications to the Global Fund to fight AIDS, TB and Malaria (Pennas T, written communication), data submitted to WHO by Kenya and other high burden countries [1], and financial analyses for the forthcoming second Global Plan to Stop TB (2006–2015) being prepared by the Stop TB Partnership. These indicate that the average cost per sm+ patient detected will increase 2–4 times when activities to improve case detection rates to 70% are implemented. Further details from authors upon request.
Treatment for sputum smear positive TB cases, existing cure rate Patient treated 140 Normal (140, 49) Nganda et al [11].
Treatment for sputum smear negative TB cases, existing cure rate Person treated 130 Normal (130, 43) Nganda et al [11].
Treatment for sputum smear positive TB cases if cure rates improved to 85% Person treated 280 Uniform (210, 350) Recent financial data submitted to WHO by Kenya and other high burden countries [1], and financial analyses for the forthcoming second Global Plan to Stop TB (2006–2015) being prepared by the Stop TB Partnership. These indicate that the average cost per patient treated will double when activities to improve cure rates are implemented. Further details from authors upon request.
Treatment for sputum smear negative TB cases if treatment completion rates improved to 85% Person treated 260 Uniform (195, 325) As above for treatment of sputum smear positive cases.
TLTI (6 months) Person treated 32 Uniform (27, 37) Bell et al [19], WHO estimates of population coverage of HIV/AIDS interventions [20]. Assume 13% adult population accesses VCT each year [20], and that 36% are HIV+, 100% are screened for TLTI, 43% start treatment of whom 38% complete treatment [21].
TLTI (lifetime) Person year of treatment 64 Uniform (54, 74) As above for TLTI for six months, plus assumption that treatment for one year is double the cost of treatment for six months.
Treatment for AIDS-related opportunistic infections and palliative care in absence of ART Person year of treatment 211 Uniform (167, 323) Unit costs used for Kenya and other low-income high HIV prevalence countries in Africa in recent estimates of the resources needed for a comprehensive response to HIV/AIDS, prepared by UNAIDS (Gutierrez JP, written communication). Kenya is in the middle of the range.
Cost of ART for a TB patient Six person months of treatment when TB and ART overlap 495 Uniform (420, 544) Unit costs used for Kenya and other low-income high HIV prevalence countries in Africa in recent estimates of the resources needed for a comprehensive response to HIV/AIDS, prepared by UNAIDS (Gutierrez JP, written communication). Kenya is in the middle of the range. Drop out rate on ART varies from 5% (optimistic scenario) to 20% [10][22].
ART, people without TB Person year of treatment 640 Uniform (487, 743) Sources and assumptions as stated above for ART for TB patients.