Resumo

HERNANDEZ-SARMIENTO, José M. et al. Thin layer agar represents a cost-effective alternative for the rapid diagnosis of multi-drug resistant tuberculosis. Rev. salud pública [online]. 2014, vol.16, n.1, pp.101-113. ISSN 0124-0064.  https://doi.org/10.15446/rsap.v16n1.31316.

Objective Using cost-benefit analysis for comparing the thin-layer agar culture method to the standard multiple proportion method used in diagnosing multidrug-resistant tuberculosis (MDR TB). Methods A cost-benefit evaluation of two diagnostic tests was made at the Corporación para Investigaciones Biológicas (CIB) in Medellín, Colombia. Results 100 patients were evaluated; 10.8 % rifampicin resistance and 14.3 % isoniazid resistance were found. A computer-based decision tree model was used for cost-effectiveness analysis (Treeage Pro); the thin-layer agar culture method was most cost-effective, having 100 % sensitivity, specificity and predictive values for detecting rifampicin and isoniazid resistance. The multiple proportion method value was calculated as being US$ 71 having an average 49 day report time compared to US$ 18 and 14 days for the thin-layer agar culture method. Discussion New technologies have been developed for diagnosing tuberculosis which are apparently faster and more effective; their operating characteristics must be evaluated as must their effectiveness in terms of cost-benefit. The present study established that using thin-layer agar culture was cheaper, equally effective and could provide results more quickly than the traditional method. This implies that a patient could receive MDR TB treatment more quickly.

Palavras-chave : Tuberculosis; multidrug-resistance; mycobacterium tuberculosis; diagnosis; cost-benefit analysis.

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