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The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia

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dc.contributor.author Terris-Prestholt, Fern
dc.contributor.author Vickerman, Peter
dc.contributor.author Torres-Rueda, Sergio
dc.contributor.author Santesso, Nancy
dc.contributor.author Sweeney, Sedona
dc.contributor.author Mallma, Patricia
dc.contributor.author Shelley, Katharine D.
dc.contributor.author Garcia Funegra, Patricia Jannet
dc.contributor.author Bronzan, Rachel
dc.contributor.author Gill, Michelle M.
dc.contributor.author Broutet, Nathalie
dc.contributor.author Wi, Teodora
dc.contributor.author Watts, Charlotte
dc.contributor.author Mabey, David
dc.contributor.author Peeling, Rosanna W.
dc.contributor.author Newman, Lori
dc.date.accessioned 2019-02-06T14:52:36Z
dc.date.available 2019-02-06T14:52:36Z
dc.date.issued 2015
dc.identifier.uri https://hdl.handle.net/20.500.12866/5328
dc.description.abstract OBJECTIVE: Rapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women. METHODS: Observed costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results. RESULTS: Although this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women. CONCLUSION: This analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries International Journal of Gynecology and Obstetrics
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Peru en_US
dc.subject Female en_US
dc.subject Humans en_US
dc.subject Latin America en_US
dc.subject Sensitivity and Specificity en_US
dc.subject Pregnancy en_US
dc.subject Africa en_US
dc.subject Algorithms en_US
dc.subject Cost-Benefit Analysis en_US
dc.subject Cost-effectiveness analysis en_US
dc.subject Diagnostic algorithms en_US
dc.subject Mass Screening/economics/methods en_US
dc.subject Pregnancy Complications, Infectious/diagnosis/drug therapy en_US
dc.subject Prenatal Diagnosis/economics/methods en_US
dc.subject Syphilis screening and treatment en_US
dc.subject Syphilis Serodiagnosis/economics/methods en_US
dc.subject Syphilis/diagnosis/drug therapy en_US
dc.subject Tanzania en_US
dc.subject Zambia en_US
dc.title The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.ijgo.2015.04.007
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.02
dc.relation.issn 1879-3479

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