Health system and household costs of preventive treatment delivery for children exposed to multidrug-resistant tuberculosis in South Africa

Thomas Wilkinson, Suereta Fortuin, Anneke C Hesseling, H Simon Schaaf, Trinh Duong, Diana M Gibb, Susan E Purchase, Lee Fairlie, Suzanne Staples, Neil Martinson, Edina Sinanovic and James A Seddon

PLOS ONE, 2026, vol. 21, issue 10, 1-16

Abstract: Background: Tuberculosis (TB) preventive treatment (TPT) is a core component of TB control. Levofloxacin was recently recommended by the World Health Organization as TPT in children exposed to multidrug-resistant tuberculosis (MDR-TB). However, the affordability and feasibility of TPT provision for governments, health services, individual households and global donors is uncertain. Methods: This costing analysis used empirical data collected alongside the TB-CHAMP clinical trial which investigated levofloxacin TPT in children exposed to MDR-TB in South Africa. We modelled the societal (health system and household) cost of levofloxacin TPT, other potential future (but not currently recommended) MDR-TB exposure TPT options and compared with drug-susceptible TPT options in children and adolescents under 15 years old. We modelled costs across 12 different medicine and formulation options for 11 paediatric dosing weight-bands using TB-CHAMP and household survey data, with national and international procurement medicine pricing. Results: Total societal costs of providing levofloxacin TPT and its monitoring per child were US$252 (0-

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0336561

DOI: 10.1371/journal.pone.0336561

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