IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0205233.html
   My bibliography  Save this article

Cost-effectiveness of GeneXpert and LED-FM for diagnosis of pulmonary tuberculosis: A systematic review

Author

Listed:
  • Karuna D Sagili
  • Malaisamy Muniyandi
  • Kayzad Soli Nilgiriwala
  • Kalpita S Shringarpure
  • Srinath Satyanarayana
  • Richard Kirubakaran
  • Sarabjit S Chadha
  • Prathap Tharyan

Abstract

Background: Early and accurate diagnosis of tuberculosis is a priority for TB programs globally to initiate treatment early and improve treatment outcomes. Currently, Ziehl–Neelsen (ZN) stain-based microscopy, GeneXpert and Light Emitting Diode-Fluorescence Microscopy (LED-FM) are used for diagnosing pulmonary drug sensitive tuberculosis. Published evidence synthesising the cost-effectiveness of these diagnostic tools is scarce. Methodology: PubMed, EMBASE and Cost-effectiveness analysis registry were searched for studies that reported on the cost-effectiveness of GeneXpert and LED-FM, compared to ZN microscopy for diagnosing pulmonary TB. Risk of bias was assessed independently by four authors using the Consensus Health Economic Criteria (CHEC) extended checklist. The data variables included the study settings, population, type of intervention, type of comparator, year of study, duration of study, type of study design, costs for the test and the comparator and effectiveness indicators. Incremental cost-effectiveness ratio (ICER) was used for assessing the relative cost-effectiveness in this review. Results: Of the 496 studies identified by the search, thirteen studies were included after removing duplicates and studies that did not fulfil inclusion criteria. Four studies compared LED-FM with ZN and nine studies compared GeneXpert with ZN. Three studies used patient cohorts and eight were modelling studies with hypothetical cohorts used to evaluate cost-effectiveness. All these studies were conducted from a health system perspective, with four studies utilising cost utility analysis. There were considerable variations in costing parameters and effectiveness indicators that precluded meta-analysis. The key findings from the included studies suggest that LED-FM and GeneXpert may be cost effective for pulmonary TB diagnosis from a health system perspective. Conclusion: Our review identifies a consistent trend of the cost effectiveness of LED-FM and GeneXpert for pulmonary TB diagnosis in different countries with diverse context of socio-economic condition, HIV burden and geographical distribution. However, all the studies used different parameters to estimate the impact of these tools and this underscores the need for improving the methodological issues related to the conduct and reporting of cost-effectiveness studies.

Suggested Citation

  • Karuna D Sagili & Malaisamy Muniyandi & Kayzad Soli Nilgiriwala & Kalpita S Shringarpure & Srinath Satyanarayana & Richard Kirubakaran & Sarabjit S Chadha & Prathap Tharyan, 2018. "Cost-effectiveness of GeneXpert and LED-FM for diagnosis of pulmonary tuberculosis: A systematic review," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-16, October.
    • Handle: RePEc:plo:pone00:0205233
    DOI: 10.1371/journal.pone.0205233
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0205233
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0205233&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0205233?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
    2. Samia Laokri & Koiné Maxime Drabo & Olivier Weil & Benoît Kafando & Sary Mathurin Dembelé & Bruno Dujardin, 2013. "Patients are paying too much for tuberculosis: a direct cost-burden evaluation in Burkina Faso," ULB Institutional Repository 2013/153198, ULB -- Universite Libre de Bruxelles.
    3. Swati Jha & Nazir Ismail & David Clark & James J Lewis & Shaheed Omar & Andries Dreyer & Violet Chihota & Gavin Churchyard & David W Dowdy, 2016. "Cost-Effectiveness of Automated Digital Microscopy for Diagnosis of Active Tuberculosis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-11, June.
    4. Samia Laokri & Maxime Koiné Drabo & Olivier Weil & Benoît Kafando & Sary Mathurin Dembélé & Bruno Dujardin, 2013. "Patients Are Paying Too Much for Tuberculosis: A Direct Cost-Burden Evaluation in Burkina Faso," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-6, February.
    5. Francis Pang & Mike Drummond & Fujian Song, 1999. "The use of meta-analysis in economic evaluation," Working Papers 173chedp, Centre for Health Economics, University of York.
    6. Nicolas A Menzies & Ted Cohen & Hsien-Ho Lin & Megan Murray & Joshua A Salomon, 2012. "Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation," PLOS Medicine, Public Library of Science, vol. 9(11), pages 1-17, November.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Sangsang Qiu & Hongqiu Pan & Simin Zhang & Xianzhen Peng & Xianzhi Zheng & Guisheng Xu & Min Wang & Jianming Wang & Hui Lu, 2015. "Is Tuberculosis Treatment Really Free in China? A Study Comparing Two Areas with Different Management Models," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-13, May.
    2. Felix Masiye & Oliver Kaonga & Joses M Kirigia, 2016. "Does User Fee Removal Policy Provide Financial Protection from Catastrophic Health Care Payments? Evidence from Zambia," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-15, January.
    3. T I Armina Padmasawitri & Gerardus W Frederix & Bachti Alisjahbana & Olaf Klungel & Anke M Hövels, 2018. "Disparities in model-based cost-effectiveness analyses of tuberculosis diagnosis: A systematic review," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-20, May.
    4. Samia Laokri & Arnaud Amoussouhui & Edgard M Ouendo & Athanase Cossi Hounnankan & Séverin Anagonou & Martin Gninafon & Ferdinand Kassa & Léon Tawo & Bruno Dujardin, 2014. "A Care Pathway Analysis of Tuberculosis Patients in Benin: Highlights on Direct Costs and Critical Stages for an Evidence-Based Decision-Making," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-8, May.
    5. Sumedh Bele & Wei Jiang & Hui Lu & Hua You & Hong Fan & Lifang Huang & Qungang Wang & Hongbing Shen & Jianming Wang, 2014. "Population Aging and Migrant Workers: Bottlenecks in Tuberculosis Control in Rural China," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-7, February.
    6. Tripathy, Prajukta & Jena, Pabitra Kumar & Mishra, Bikash Ranjan, 2024. "Systematic literature review and bibliometric analysis of energy efficiency," Renewable and Sustainable Energy Reviews, Elsevier, vol. 200(C).
    7. Elizabeth T Cafiero-Fonseca & Andrew Stawasz & Sydney T Johnson & Reiko Sato & David E Bloom, 2017. "The full benefits of adult pneumococcal vaccination: A systematic review," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-23, October.
    8. Ludoviko Zirimenya & Fatima Mahmud-Ajeigbe & Ruth McQuillan & You Li, 2020. "A systematic review and meta-analysis to assess the association between urogenital schistosomiasis and HIV/AIDS infection," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 14(6), pages 1-13, June.
    9. Trang Nguyen & Sara Holton & Thach Tran & Jane Fisher, 2019. "Informal mental health interventions for people with severe mental illness in low and lower middle-income countries: A systematic review of effectiveness," International Journal of Social Psychiatry, , vol. 65(3), pages 194-206, May.
    10. Natalya Ivanova & Ekaterina Zolotova, 2023. "Landolt Indicator Values in Modern Research: A Review," Sustainability, MDPI, vol. 15(12), pages 1-22, June.
    11. Su Keng Tan & Wai Keung Leung & Alexander Tin Hong Tang & Roger A Zwahlen, 2017. "Effects of mandibular setback with or without maxillary advancement osteotomies on pharyngeal airways: An overview of systematic reviews," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-20, October.
    12. Vecchio, Riccardo & Caso, Gerarda & Cembalo, Luigi & Borrello, Massimiliano, 2020. "Is respondents’ inattention in online surveys a major issue for research?," Economia agro-alimentare / Food Economy, Italian Society of Agri-food Economics/Società Italiana di Economia Agro-Alimentare (SIEA), vol. 22(01), March.
    13. Alessandro Concari & Gerjo Kok & Pim Martens, 2020. "A Systematic Literature Review of Concepts and Factors Related to Pro-Environmental Consumer Behaviour in Relation to Waste Management Through an Interdisciplinary Approach," Sustainability, MDPI, vol. 12(11), pages 1-50, May.
    14. Damiano Pizzol & Mike Trott & Igor Grabovac & Mario Antunes & Anna Claudia Colangelo & Simona Ippoliti & Cristian Petre Ilie & Anne Carrie & Nicola Veronese & Lee Smith, 2021. "Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review," IJERPH, MDPI, vol. 18(11), pages 1-11, May.
    15. Yehuda Weizman & Oren Tirosh & Jeanie Beh & Franz Konstantin Fuss & Sonja Pedell, 2021. "Gait Assessment Using Wearable Sensor-Based Devices in People Living with Dementia: A Systematic Review," IJERPH, MDPI, vol. 18(23), pages 1-14, December.
    16. Alessandro Margherita & Emanuele Banchi & Alfredo Biffi & Gianluca di Castri & Rocco Morelli, 2022. "Beyond Total Cost Management (TCM) to Systemic Value Management (SVM): Transformational Trends and a Research Manifesto for an Evolving Discipline," Sustainability, MDPI, vol. 14(19), pages 1-16, October.
    17. Stefano D’Angelo & Angelo Cavallo & Antonio Ghezzi & Francesco Di Lorenzo, 2024. "Understanding corporate entrepreneurship in the digital age: a review and research agenda," Review of Managerial Science, Springer, vol. 18(12), pages 3719-3774, December.
    18. Fabio Magnacca & Riccardo Giannetti, 2024. "Management accounting and new product development: a systematic literature review and future research directions," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 28(2), pages 651-685, June.
    19. Jacob Elnaggar & Fern Tsien & Lucio Miele & Chindo Hicks & Clayton Yates & Melisa Davis, 2019. "An Integrative Genomics Approach for Associating Genetic Susceptibility with the Tumor Immune Microenvironment in Triple Negative Breast Cancer," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 15(1), pages 1-12, February.
    20. Michael Masaracchio & William J Hanney & Xinliang Liu & Morey Kolber & Kaitlin Kirker, 2017. "Timing of rehabilitation on length of stay and cost in patients with hip or knee joint arthroplasty: A systematic review with meta-analysis," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-22, June.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0205233. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.