title: The hidden costs of installing Xpert machines in a tuberculosis high-burden country: experiences from Nigeria.
abstract: BACKGROUND
  Since the endorsement of GeneXpert MTB/RIF by the WHO, many countries have embarked on implementing this technology.
  
  
  OBJECTIVE
  We outline the cost of installing GeneXpert in district hospitals in Abuja, Nigeria.
  
  
  METHODS
  We prospectively documented costs related to the installation of GeneXpert at five sites. Costs were collected from receipts received from suppliers and normalized to USD 2012 values.
  
  
  RESULTS
  Costs were often identified after initiating installation for many reasons. Installation varied widely between sites with sufficient space and power supply; sites with insufficient space or power supply and costs not directly associated with site installation. The basic cost for installation was USD 2,621.98 per machine. Sites that required additional space cost close to USD 7,000.00.
  
  
  CONCLUSIONS
  Space and power requirements have a significant effect on installation costs. Countries need to carefully consider the placement of Xpert machines based on the quality and size of the available infrastructure.
authors.affiliation: Tuberculosis and Leprosy Control Programme Unit, Department of Public Health and Human Services, Federal Capital Territory, Abuja, Nigeria.
authors.forename: Saddiq Tsimiri
authors.initials: ST
authors.lastname: Abdurrahman
authors.affiliation: Zankli Medical Centre, Abuja, Nigeria.
authors.forename: Nnamdi
authors.initials: N
authors.lastname: Emenyonu
authors.affiliation: National TB, Leprosy & Buruli Ulcer Control Programme, Nigeria.
authors.forename: Olusegun Joshua
authors.initials: OJ
authors.lastname: Obasanya
authors.affiliation: Zankli Medical Centre, Abuja, Nigeria.
authors.forename: Lovett
authors.initials: L
authors.lastname: Lawson
authors.affiliation: Liverpool School of Tropical Medicine, United Kingdom.
authors.forename: Russell
authors.initials: R
authors.lastname: Dacombe
authors.affiliation: Tuberculosis and Leprosy Control Programme Unit, Department of Public Health and Human Services, Federal Capital Territory, Abuja, Nigeria.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Muhammad
authors.affiliation: Zankli Medical Centre, Abuja, Nigeria ; Liverpool School of Tropical Medicine, United Kingdom.
authors.forename: Olanrewaju
authors.initials: O
authors.lastname: Oladimeji
authors.affiliation: Liverpool School of Tropical Medicine, United Kingdom.
authors.forename: Luis Eduardo
authors.initials: LE
authors.lastname: Cuevas
mesh_terms: D003362:Cost-Benefit Analysis; D003906:Developing Countries / Q000191:economics; D019719:Diagnostic Equipment / Q000191:economics*; D014943:Global Health / Q000191:economics; D006295:Health Resources / Q000191:economics; D006801:Humans; D009549:Nigeria / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000191:economics*
keywords: Tuberculosis; Xpert-Installation; hidden cost; low resource –settings; operational research