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Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa.
Sex Transm Dis. 2011 Nov; 38(11):997-1003.ST

Abstract

BACKGROUND

A dual nontreponemal/treponemal point-of-care test (Dual-POC) that simultaneously detects both nontreponemal and treponemal antibodies has been developed and evaluated. In this study, we compare the health and economic outcomes of the new test with existing syphilis tests/testing algorithms in a high prevalence setting.

METHODS

We used a cohort decision analysis model to examine 4 testing/screening algorithms; the Dual-POC test, the laboratory-based rapid plasma reagin and Treponema pallidum haemagglutination assay (RPR+TPHA) algorithm, an onsite RPR testing, and point-of-care treponemal immunochromatographic strip (ICS) testing. Outcomes included miscarriage, stillbirth, congenital syphilis, low birth weight, and neonatal death. Disability-adjusted life-years were estimated for all health outcomes. The analytic horizon was the life expectancy for the mother and child.

RESULTS

For a cohort of 1000 pregnant women in a historically high syphilis prevalence population (10% infected and 15% previously infected), the model predicted a total of 39 adverse pregnancy outcomes if no serologic screening were performed; 13 for the laboratory-based RPR+TPHA; 11 for the on-site RPR strategy; 5 for the Dual-POC strategy; and 2 for the ICS strategy. On the basis of assumption that the cost of ICS and the Dual-POC tests were the same, the ICS strategy was the most cost saving (saved $30,000) followed by the Dual-POC strategy (saved $27,000).

CONCLUSIONS

The dual-POC test may help save cost in resource-poor settings where disease prevalence (and loss to follow-up) is high, while substantially reducing overtreatment.

Authors+Show Affiliations

Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. Kowusuedusei@cdc.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

21992974

Citation

Owusu-Edusei, Kwame, et al. "Cost-effectiveness of a Dual Non-treponemal/treponemal Syphilis Point-of-care Test to Prevent Adverse Pregnancy Outcomes in sub-Saharan Africa." Sexually Transmitted Diseases, vol. 38, no. 11, 2011, pp. 997-1003.
Owusu-Edusei K, Gift TL, Ballard RC. Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa. Sex Transm Dis. 2011;38(11):997-1003.
Owusu-Edusei, K., Gift, T. L., & Ballard, R. C. (2011). Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa. Sexually Transmitted Diseases, 38(11), 997-1003. https://doi.org/10.1097/OLQ.0b013e3182260987
Owusu-Edusei K, Gift TL, Ballard RC. Cost-effectiveness of a Dual Non-treponemal/treponemal Syphilis Point-of-care Test to Prevent Adverse Pregnancy Outcomes in sub-Saharan Africa. Sex Transm Dis. 2011;38(11):997-1003. PubMed PMID: 21992974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness of a dual non-treponemal/treponemal syphilis point-of-care test to prevent adverse pregnancy outcomes in sub-Saharan Africa. AU - Owusu-Edusei,Kwame,Jr AU - Gift,Thomas L, AU - Ballard,Ronald C, PY - 2011/10/14/entrez PY - 2011/10/14/pubmed PY - 2012/2/10/medline SP - 997 EP - 1003 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 38 IS - 11 N2 - BACKGROUND: A dual nontreponemal/treponemal point-of-care test (Dual-POC) that simultaneously detects both nontreponemal and treponemal antibodies has been developed and evaluated. In this study, we compare the health and economic outcomes of the new test with existing syphilis tests/testing algorithms in a high prevalence setting. METHODS: We used a cohort decision analysis model to examine 4 testing/screening algorithms; the Dual-POC test, the laboratory-based rapid plasma reagin and Treponema pallidum haemagglutination assay (RPR+TPHA) algorithm, an onsite RPR testing, and point-of-care treponemal immunochromatographic strip (ICS) testing. Outcomes included miscarriage, stillbirth, congenital syphilis, low birth weight, and neonatal death. Disability-adjusted life-years were estimated for all health outcomes. The analytic horizon was the life expectancy for the mother and child. RESULTS: For a cohort of 1000 pregnant women in a historically high syphilis prevalence population (10% infected and 15% previously infected), the model predicted a total of 39 adverse pregnancy outcomes if no serologic screening were performed; 13 for the laboratory-based RPR+TPHA; 11 for the on-site RPR strategy; 5 for the Dual-POC strategy; and 2 for the ICS strategy. On the basis of assumption that the cost of ICS and the Dual-POC tests were the same, the ICS strategy was the most cost saving (saved $30,000) followed by the Dual-POC strategy (saved $27,000). CONCLUSIONS: The dual-POC test may help save cost in resource-poor settings where disease prevalence (and loss to follow-up) is high, while substantially reducing overtreatment. SN - 1537-4521 UR - https://www.unboundmedicine.com/medline/citation/21992974/Cost_effectiveness_of_a_dual_non_treponemal/treponemal_syphilis_point_of_care_test_to_prevent_adverse_pregnancy_outcomes_in_sub_Saharan_Africa_ L2 - http://dx.doi.org/10.1097/OLQ.0b013e3182260987 DB - PRIME DP - Unbound Medicine ER -