Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting

dc.contributor.advisorWilkinson, Thomas
dc.contributor.authorFortuin, Suereta
dc.date.accessioned2021-07-30T13:45:43Z
dc.date.available2021-07-30T13:45:43Z
dc.date.issued2021
dc.date.updated2021-07-30T13:45:10Z
dc.description.abstractBackground The incidence of TB in children under 15 years, accounts for 8% of the global TB burden. In 2018, the World Health Organisation (WHO) estimated that there were approximately 11 000 multi-drug resistant (MDR) TB cases in South Africa. Despite having very clear guidelines on TB treatment programs and management, availability of inexpensive diagnostic tests, curative and preventive therapies, and the widespread use of the BCG vaccines, South Africa continues to have the highest the number of MDR-TB cases per capita. Levofloxacin is used as part of the group of fluoroquinolones in the drug regimen recommended in the treatment of MDR-TB patients. In addition to investigating the clinical impact of levofloxacin as preventative antibiotic therapy, the expected costs of the intervention will be a critical input to determining feasibility and costs effectiveness, which will inform policy and implementation considerations. Methods We performed a cost analysis on using existing data from the Tuberculosis Child Multi-drug-resistant Preventative Therapy (TB-CHAMP) trial, conducted from a TB control program perspective. We used data from 510 childhood household contacts of MDR-TB patients in South Africa that were treated with levofloxacin for 6 months as a preventative therapy for MDR-TB. In our analysis we evaluated the estimated health system cost associated with provision of levofloxacin to childhood contacts of MDRTB patients in South Africa. Results The mean total cost of treating a child household contact, irrespective of their weight band is ZAR 5,289.79. When the cost were analysed by weight categories we found that the cost increased by weight category; ZAR 2,146.78 (under 5 kg), ZAR 4,714.58 (between 5-15.9 kg) and ZAR 6,606.67 (over 16 kg). We performed a comprehensive sensitivity analysis and found that the scheduled clinic visits were the major cost driver. Aside from the scheduled visits we observed that there was an increase in additional health service utilization for children with a weight more than 5kg. Conclusion We envisage that based on our analysis we will be able to inform policy decisions about the management and prevention of childhood household contacts of MDR-TB patients in developing TB themselves.
dc.identifier.apacitationFortuin, S. (2021). <i>Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/33676en_ZA
dc.identifier.chicagocitationFortuin, Suereta. <i>"Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021. http://hdl.handle.net/11427/33676en_ZA
dc.identifier.citationFortuin, S. 2021. Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/33676en_ZA
dc.identifier.ris TY - Master Thesis AU - Fortuin, Suereta AB - Background The incidence of TB in children under 15 years, accounts for 8% of the global TB burden. In 2018, the World Health Organisation (WHO) estimated that there were approximately 11 000 multi-drug resistant (MDR) TB cases in South Africa. Despite having very clear guidelines on TB treatment programs and management, availability of inexpensive diagnostic tests, curative and preventive therapies, and the widespread use of the BCG vaccines, South Africa continues to have the highest the number of MDR-TB cases per capita. Levofloxacin is used as part of the group of fluoroquinolones in the drug regimen recommended in the treatment of MDR-TB patients. In addition to investigating the clinical impact of levofloxacin as preventative antibiotic therapy, the expected costs of the intervention will be a critical input to determining feasibility and costs effectiveness, which will inform policy and implementation considerations. Methods We performed a cost analysis on using existing data from the Tuberculosis Child Multi-drug-resistant Preventative Therapy (TB-CHAMP) trial, conducted from a TB control program perspective. We used data from 510 childhood household contacts of MDR-TB patients in South Africa that were treated with levofloxacin for 6 months as a preventative therapy for MDR-TB. In our analysis we evaluated the estimated health system cost associated with provision of levofloxacin to childhood contacts of MDRTB patients in South Africa. Results The mean total cost of treating a child household contact, irrespective of their weight band is ZAR 5,289.79. When the cost were analysed by weight categories we found that the cost increased by weight category; ZAR 2,146.78 (under 5 kg), ZAR 4,714.58 (between 5-15.9 kg) and ZAR 6,606.67 (over 16 kg). We performed a comprehensive sensitivity analysis and found that the scheduled clinic visits were the major cost driver. Aside from the scheduled visits we observed that there was an increase in additional health service utilization for children with a weight more than 5kg. Conclusion We envisage that based on our analysis we will be able to inform policy decisions about the management and prevention of childhood household contacts of MDR-TB patients in developing TB themselves. DA - 2021 DB - OpenUCT DP - University of Cape Town KW - public health LK - https://open.uct.ac.za PY - 2021 T1 - Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting TI - Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting UR - http://hdl.handle.net/11427/33676 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/33676
dc.identifier.vancouvercitationFortuin S. Costing analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/33676en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectpublic health
dc.titleCosting analysis of levofloxacin as antibiotic prophylaxis for pediatric household contacts of multi-drug resistant tuberculosis patients in a South African setting
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
Files
Original bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
thesis_hsf_2021_fortuin suereta.pdf
Size:
5.93 MB
Format:
Adobe Portable Document Format
Description:
License bundle
Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Collections