Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Research Abstract Details 

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Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Abstract Text:

Bruce R Schackman,Christopher P Neukermans,Sandy N Nerette Fontain,Claudine Nolte,Patrice Joseph,Jean W Pape,Daniel W Fitzgerald,

BACKGROUND: New rapid syphilis tests permit simple and immediate diagnosis and treatment at a single clinic visit. We compared the cost-effectiveness, projected health outcomes, and annual cost of screening pregnant women using a rapid syphilis test as part of scaled-up prenatal testing to prevent mother-to-child HIV transmission in Haiti. METHODS AND FINDINGS: A decision analytic model simulated health outcomes and costs separately for pregnant women in rural and urban areas. We compared syphilis syndromic surveillance (rural standard of care), rapid plasma reagin test with results and treatment at 1-wk follow-up (urban standard of care), and a new rapid test with immediate results and treatment. Test performance data were from a World Health Organization-Special Programme for Research and Training in Tropical Diseases field trial conducted at the GHESKIO Center Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes in Port-au-Prince. Health outcomes were projected using historical data on prenatal syphilis treatment efficacy and included disability-adjusted life years (DALYs) of newborns, congenital syphilis cases, neonatal deaths, and stillbirths. Cost-effectiveness ratios are in US dollars/DALY from a societal perspective; annual costs are in US dollars from a payer perspective. Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings. Results are sensitive to regional syphilis prevalence, rapid test sensitivity, and the return rate for follow-up visits. Integrating rapid syphilis testing into a scaled-up national HIV testing and prenatal care program would prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually at a cost of $525,000. CONCLUSIONS: In Haiti, integrating a new rapid syphilis test into prenatal care and HIV testing would prevent congenital syphilis cases and stillbirths, and is cost-effective. A similar approach may be beneficial in other resource-poor countries that are scaling up prenatal HIV testing.

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Publishing Authors By Initials

BR Schackman,CP Neukermans,SN Fontain,C Nolte,P Joseph,JW Pape,DW Fitzgerald,

For similar natural sciences: time: time factors research abstracts see: natural sciences: time: time factors research

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Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: PLoS medicine

VOLUME: 4

Page Numbers: e183

Journal Abbreviation: PLoS Med.

ISSN: 1549-1676

DAY: 3

MONTH: May

YEAR: 2007

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Information

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LANGUAGE: eng

NlmUniqueID: 101231360

Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Keywords Mesh Terms:

KEYWORDS: Time Factors

MESH TERMS: drug therapy

Chemical & Substance for Abstract: Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti. Information

Substance Name: Reagent Kits, Diagnostic

Registry Number: 0

Grant and Affiliation Information for Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti.

AFFILIATION: Department of Public Health, Weill Medical College, Cornell University, New York, New York, United States of America. brs2006@med.cornell.edu

Country: United States

AGENCY: United States FIC

GRANT: TW006901

ACRONYM: TW

MEDLINETA: PLoS Med

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