The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies

• DOI: 10.1371/journal.pone.0171917
• Publication Date: 2017-02-24T18:47:20Z
• Authors: Godfather Dickson...; Sayoki Mfinanga; Victoria Simms; Sokoine Kivuyo; Christian Bottomley; Neil Hawkins; Thomas S. Harrison; Shabbar Jaffar; Lorna Guinness
• Keywords: Lost to follow-up

Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on service resources used by patients and their within antiretroviral (ART) programmes in Africa. Material methods The study was nested a large trial, which evaluated screening cryptococcal meningitis tuberculosis short initial period of home-based adherence support initiating ART advanced HIV disease Tanzania Zambia. economic evaluation done alone. We estimated providing routine services from provider's perspective using micro-costing approach. Incremental different novel components were also estimated. All converted into US dollars (US$) based 2012 prices. Results Of 870 individuals enrolled Tanzania, 434 intervention arm 436 standard care/control arm. Overall, median (IQR) age CD4 cell count at enrolment 38 [31, 44] years 52 [20, 89] cells/mm3, respectively. mean per patient over first three months one year follow up following initiation US$ 107 (95%CI 101–112) 265 254–275) drugs, clinic visits hospital admission constituted 50%, 19%, 19% total cost year, while diagnostic tests non-ART drugs (co-trimoxazole) accounted 10% 2% costs. incremental to 59 (p<0.001; 95%CI 52–67) 67(p<0.001; 50–83). This equivalent an increase 55% 51%–59%) months, 25% 20%–30%) up.