Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya

被引:11
作者
Bulterys, Michelle Ann [1 ,2 ]
Oyaro, Patrick [1 ,3 ]
Brown, Evelyn [4 ]
Yongo, Nashon [4 ]
Karauki, Enericah [4 ]
Wagude, James [5 ]
Kingwara, Leonard [6 ]
Bowen, Nancy [6 ]
Njogo, Susan [7 ]
Wagner, Anjuli D. [1 ,2 ]
Mukui, Irene [1 ,2 ]
Oluoch, Frederick [6 ]
Abuogi, Lisa [8 ]
Patel, Rena [1 ,2 ,9 ]
Sharma, Monisha [1 ,2 ]
机构
[1] Univ Washington, Dept Epidemiol, Seattle, WA 98105 USA
[2] Univ Washington, Dept Global Hlth, Seattle, WA 98105 USA
[3] Hlth Innovat Kenya, Kisumu, Kenya
[4] Univ Washington Kenya, Dept HIV Res, Nairobi, Kenya
[5] Dept Hlth, Siaya, Siaya County, Kenya
[6] Natl Publ Hlth Lab, Natl HIV Reference Lab, Nairobi, Kenya
[7] Minist Hlth, Natl AIDS & STI Control Programme, Nairobi 19361, Kenya
[8] Univ Colorado, Dept Pediat, Denver, CO 80045 USA
[9] Univ Washington, Div Allergy & Infect Dis, Dept Med, Seattle, WA 98105 USA
关键词
costing; point-of-care viral load testing; viral load test; HIV care; HIV management;
D O I
10.3390/diagnostics11010140
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The number of people living with HIV (PLHIV) in need of treatment monitoring in low-and-middle-income countries is rapidly expanding, straining existing laboratory capacity. Point-of-care viral load (POC VL) testing can alleviate the burden on centralized laboratories and enable faster delivery of results, improving clinical outcomes. However, implementation costs are uncertain and will depend on clinic testing volume. We sought to estimate the costs of decentralized POC VL testing compared to centralized laboratory testing for adults and children receiving HIV care in Kenya. Methods: We conducted microcosting to estimate the per-patient costs of POC VL testing compared to known costs of centralized laboratory testing. We completed time-and-motion observations and stakeholder interviews to assess personnel structures, staff time, equipment costs, and laboratory processes associated with POC VL administration. Capital costs were estimated using a 5 year lifespan and a 3% annual discount rate. Results: We estimated that POC VL testing cost USD $24.25 per test, assuming a clinic is conducting 100 VL tests per month. Test cartridge and laboratory equipment costs accounted for most of the cost (62% and 28%, respectively). Costs varied by number of VL tests conducted at the clinic, ranging from $54.93 to $18.12 per test assuming 20 to 500 VL tests per month, respectively. A VL test processed at a centralized laboratory was estimated to cost USD $25.65. Conclusion: POC VL testing for HIV treatment monitoring can be feasibly implemented in clinics within Kenya and costs declined with higher testing volumes. Our cost estimates are useful to policymakers in planning resource allocation and can inform cost-effectiveness analyses evaluating POC VL testing.
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页数:13
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