Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya

Bulterys, Michelle Ann and Oyaro, Patrick and Brown, Evelyn and Yongo, Nashon and Karauki, Enericah and Wagude, James and Kingwara, Leonard and Bowen, Nancy and Njogo, Susan and Wagner, Anjuli D. and Mukui, Irene and Oluoch, Frederick and Abuogi, Lisa and Patel, Rena and Sharma, Monisha (2021) Costs of Point-of-Care Viral Load Testing for Adults and Children Living with HIV in Kenya. Diagnostics, 11 (1). p. 140. ISSN 2075-4418

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Abstract

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.

Item Type: Article
Subjects: SCI Archives > Medical Science
Depositing User: Managing Editor
Date Deposited: 06 Jan 2023 08:01
Last Modified: 16 Oct 2024 04:36
URI: http://science.classicopenlibrary.com/id/eprint/334

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