Resource implications of the latent tuberculosis cascade of care: a time and motion study in five countries

Table 5 Total time^a required for contact management and LTBI care for all steps along the LTBI Cascade of Care

	Identify contacts	Place TST^b	Read TST^b	Conduct Medical Evaluation^b,c	Recommend and Discuss LTBI Treatment^b,c	LTBI Follow-up Visit^b,c,d	Total Time Per Index Case (hours)
Country	(A)	(B)	(C)	(D)	(E)	(F)	Σ (A-F)
LMIC
Benin
Doctors	-	-	-	18.9	10.7	-	0.50
Nurses	7.5	17.6	11.3	-	14.0	63.4	1.90
Ghana
Doctors	-	-	-	42.7	24.2	-	1.12
Nurses	7.5	39.6	25.5	-	31.7	143.0	4.12
Indonesia
Doctors	-	-	-	16.0	9.1	-	0.42
Nurses	7.5	14.9	9.6	-	11.9	53.6	1.63
Vietnam
Doctors	-	-	-	13.6	7.7	-	0.36
Nurses	7.5	12.6	8.1	-	10.1	45.5	1.40
High-Income
Canada
Doctors	-	-	-	13.1	14.3	-	0.46
Nurses	12.8	56.9	43.2	-	16.0	44.4	2.89

^aPredicted time (min) for each step from linear mixed models (LMM) shown in Supplementary Tables S1–5
^bAssumes step accounts for all household contacts (HHC) for one index case; based on average number of HHC per index patient in each country observed in the main study: Benin = 3.9; Ghana = 8.8; Indonesia = 3.3; Vietnam = 2.8; Canada = 3.6
^cAssumes a prevalence of TST positive for HHC of index patient is 50% in LMIC and 28% in Canada (Fox 2013)
^dAssumes 5 follow-up visits for 6 months of INH treatment of LTBI in LMIC and 3 follow-up visits for 4 months of RIF treatment of LTBI in Canada

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