Moran A, Kula N, Jagwer G, Broughton E, Pillay Y, Mvusi L, AlMossawi H, Ndjeka N, Mametja D, Dlamini C, Ahmedov S, Matji R, Kak N
University Research Co (URC), Chevy Chase, MD, USA.
URC, Pretoria, Gauteng.
Int J Tuberc Lung Dis. 2020 Jun 1;24(6):612-618. doi: 10.5588/ijtld.19.0552.
While South Africa has improved access to tuberculosis (TB) treatment and care, the 2015 treatment success rate for multidrug-resistant TB (MDR-TB) remains low, at 55%. Community-based TB treatment and care improves patient retention compared to the standard of care alone. To assess the cost of a USAID-funded community-based TB model in Nelson Mandela Bay Health District (NMBHD), Eastern Cape Province, South Africa compared to the national standard of care alone. We estimated the cost of community-based DR-TB treatment and adherence support compared to the standard of care alone. Average overall costs were US$2827 lower per patient on the community-based model than the standard of care alone. The per-patient cost of the community-based model is lower than the standard of care alone. Assuming the costs and effects of a community-based model implemented in NMBHD were observed at a larger scale, implementing the model could reduce overall health system costs.
尽管南非在结核病（TB）治疗和护理的可及性方面有所改善，但2015年耐多药结核病（MDR-TB）的治疗成功率仍然很低，仅为55%。与单纯的标准护理相比，基于社区的结核病治疗和护理能提高患者留存率。为评估美国国际开发署资助的、位于南非东开普省纳尔逊·曼德拉湾卫生区（NMBHD）的基于社区的结核病模式相对于单纯国家标准护理的成本。我们估算了基于社区的耐多药结核病治疗及依从性支持相对于单纯标准护理的成本。基于社区的模式下，每位患者的平均总成本比单纯的标准护理低2827美元。基于社区的模式下每位患者的成本低于单纯的标准护理。假设在NMBHD实施的基于社区的模式的成本和效果能在更大范围内得到体现，那么实施该模式可降低整个卫生系统的成本。
