Cost-effectiveness Analysis of Xpert MTB/RIF Ultra for the Diagnosis of HIV-Associated Tuberculous Meningitis

Clicks: 2
ID: 316479
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #454 of 531 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 531 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background HIV-associated tuberculous meningitis (TBM) is the most lethal form of extrapulmonary tuberculosis, with high mortality in sub-Saharan Africa. Due to the limited diagnostic performance of current testing, empiric treatment is frequently required as untreated TBM is almost universally fatal. Xpert MTB/RIF Ultra (Xpert Ultra) is the World Health Organization (WHO) recommended first line diagnostic test for TBM but is costly relative to standard of care. We performed a cost-effectiveness analysis of Xpert Ultra for HIV-associated TBM in Zambia. Methods We developed a decision-analytic model comparing a diagnostic strategy guided by CSF Xpert Ultra plus standard of care (CSF biochemistry and clinical suspicion) versus standard of care alone in adults with HIV and suspected TBM. Costs were calculated from a healthcare perspective including medication, supplies, personnel, and overhead. The primary outcome was the incremental cost-effectiveness ratio (ICER) in US dollars per quality-adjusted life-year (QALY) gained. Sensitivity analyses and cost-effectiveness acceptability curves (CEAC) assessed robustness across a range of willingness-to-pay (WTP) thresholds. Results Xpert Ultra plus standard of care was cost-effective yielding an ICER of $242.76 per QALY gained. The number needed to test to prevent one TBM death was 125. Sensitivity analyses showed cost-effectiveness was most influenced by TBM prevalence, TBM mortality in treated patients, and the probability of empiric treatment. Xpert Ultra was approximately 88% likely to be cost-effective across a broad WTP range. Conclusions Xpert Ultra is cost-effective for diagnosing HIV-associated TBM in Zambia. These findings support WHO guidelines recommending Xpert Ultra in high-burden, resource-limited settings.
Reference Key
openalex_W7164034632 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Omar K. Siddiqi, Beate Jahn, Ursula Rochau, Stewart Walukaga, Radha Rajasingham, Uwe Siebert
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag348
URL
https://doi.org/10.1093/cid/ciag348
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.