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dc.contributor.authorBada, F.O.
dc.contributor.authorOkpokoro, E.
dc.contributor.authorBlok, N.
dc.date.accessioned2019-03-29T14:47:33Z
dc.date.available2019-03-29T14:47:33Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85059829417&doi=10.1186%2fs12879-018-3636-1&partnerID=40&md5=6deeac9b8f666584d4b94b8845f692e5
dc.identifier.urihttp://hdl.handle.net/10713/8645
dc.description.abstractBackground: Nigeria accounts for a significant proportion of the global drug-resistant tuberculosis (DR-TB) burden, a large proportion of which goes untreated. Different models for managing DR-TB treatment with varying levels of hospitalization are in use across Nigeria, however costing evidence is required to guide the scale up of DR-TB care. We aimed to estimate and compare the costs of different DR-TB treatment and care models in Nigeria. Methods: We estimated the costs associated with three models of DR-TB treatment and care: Model (A) patients are hospitalized throughout the 8-month intensive phase, Model (B) patients are partially hospitalized during the intensive phase and Model (C) is entirely ambulatory. Costs of treatment, in-patient and outpatient care and diagnostic and monitoring tests were collected using a standardized data collection sheet from six sites through an ingredient's approach and cost models were based on the Nigerian National Tuberculosis, Leprosy and Buruli Ulcer Guideline - Sixth Edition (2014) and Guideline for programmatic and clinical management of drug-resistant tuberculosis in Nigeria (2015). Results: Assuming adherence to the Nigerian DR-TB guidelines, the per patient cost of Model A was 18,528 USD, Model B 15,159 USD and Model C 9425 USD. Major drivers of cost included hospitalization (Models A and B) and costs of out-patient consultations and supervision (Model C). Conclusion: Utilizing a decentralized ambulatory model, is a more economically viable approach for the expansion of DR-TB care in Nigeria, given that patient beds for DR-TB treatment and care are limited and costs of hospitalized treatment are considerably more expensive than ambulatory models. Scale-up of less expensive ambulatory care models should be carefully considered in particular, when treatment efficacy is demonstrated to be similar across the different models to allow for patients not requiring hospitalization to be cared for in the least expensive way. Copyright 2019 The Author(s).en_US
dc.description.sponsorshipThis work was supported by the Global Fund New Funding Model MDR-TB grant to Nigeria with IHVN serving as the principal recipient. The funder had no role in the design, data collection, analysis and interpretation of results in this study.en_US
dc.description.urihttps://dx.doi.org/10.1186/s12879-018-3636-1en_US
dc.language.isoen_USen_US
dc.publisherBioMed Central Ltd.en_US
dc.relation.ispartofBMC Infectious Diseases
dc.subjectCosten_US
dc.subjectDecentralized ambulatory careen_US
dc.subjectDrug-resistant tuberculosisen_US
dc.subjectHospitalizationen_US
dc.titleCost of three models of care for drug-resistant tuberculosis patients in Nigeriaen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12879-018-3636-1
dc.identifier.pmid30630429


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