RESUMO
Digital adherence technologies are increasingly used to support tuberculosis (TB) treatment adherence. Using microcosting, we estimated healthcare system costs (in 2022 US dollars) of 2 digital adherence technologies, 99DOTS medication sleeves and video-observed therapy (VOT), implemented in demonstration projects during 2018-2021. We also obtained cost estimates for standard directly observed therapy (DOT). Estimated per-person costs of 99DOTS for drug-sensitive TB were $98 in Bangladesh (n = 719), $119 in the Philippines (n = 396), and $174 in Tanzania (n = 976). Estimated per-person costs of VOT were $1,154 in Haiti (87 drug-sensitive), $304 in Moldova (173 drug-sensitive), $452 in Moldova (135 drug-resistant), and $661 in the Philippines (110 drug-resistant). 99DOTS costs may be similar to or less expensive than standard DOT. VOT is more expensive, although in some settings, labor cost offsets or economies of scale may yield savings. 99DOTS and VOT may yield savings to local programs if donors cover infrastructure costs.
Assuntos
Terapia Diretamente Observada , Custos de Cuidados de Saúde , Humanos , Bangladesh , Haiti , RendaRESUMO
This field report describes Health through Wall's experience working in the largest men's prison in Haiti. Though there have been many reports of prison peer health education programs, this field report further describes how peers can increase the (self-reported) interest and uptake of HIV testing. More than 400 anonymous surveys were collected. Preliminary results indicate that the peers had a significant impact on self-reported interest in taking the HIV test.