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Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya
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 d...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832863/ https://www.ncbi.nlm.nih.gov/pubmed/33477850 http://dx.doi.org/10.3390/diagnostics11010140 |
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author | Bulterys, Michelle Ann Oyaro, Patrick Brown, Evelyn Yongo, Nashon Karauki, Enericah Wagude, James Kingwara, Leonard Bowen, Nancy Njogo, Susan Wagner, Anjuli D. Mukui, Irene Oluoch, Frederick Abuogi, Lisa Patel, Rena Sharma, Monisha |
author_facet | Bulterys, Michelle Ann Oyaro, Patrick Brown, Evelyn Yongo, Nashon Karauki, Enericah Wagude, James Kingwara, Leonard Bowen, Nancy Njogo, Susan Wagner, Anjuli D. Mukui, Irene Oluoch, Frederick Abuogi, Lisa Patel, Rena Sharma, Monisha |
author_sort | Bulterys, Michelle Ann |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7832863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78328632021-01-26 Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya Bulterys, Michelle Ann Oyaro, Patrick Brown, Evelyn Yongo, Nashon Karauki, Enericah Wagude, James Kingwara, Leonard Bowen, Nancy Njogo, Susan Wagner, Anjuli D. Mukui, Irene Oluoch, Frederick Abuogi, Lisa Patel, Rena Sharma, Monisha Diagnostics (Basel) Article 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. MDPI 2021-01-19 /pmc/articles/PMC7832863/ /pubmed/33477850 http://dx.doi.org/10.3390/diagnostics11010140 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Bulterys, Michelle Ann Oyaro, Patrick Brown, Evelyn Yongo, Nashon Karauki, Enericah Wagude, James Kingwara, Leonard Bowen, Nancy Njogo, Susan Wagner, Anjuli D. Mukui, Irene Oluoch, Frederick Abuogi, Lisa Patel, Rena Sharma, Monisha Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title | Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title_full | Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title_fullStr | Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title_full_unstemmed | Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title_short | Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya |
title_sort | costs of point-of-care viral load testing for adults and children living with hiv in kenya |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832863/ https://www.ncbi.nlm.nih.gov/pubmed/33477850 http://dx.doi.org/10.3390/diagnostics11010140 |
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