Antenatal Syphilis Screening Using Point-Of-Care Testing in Low- and Middle-Income Countries in Asia and Latin America: A Cost-Effectiveness Analysis

• DOI: 10.1371/journal.pone.0127379
• Publication Date: 2015-05-26T18:05:54Z
• Authors: Andreas Kuznik; Christine Muhumuza; Henry Komakech; Elsa M. R. Marques; Mohammed Lamorde
• Keywords: Asia; Science; Cost-Benefit Analysis; Q; R; 1. No poverty; Congenital syphilis; Antenatal care; Models, Theoretical; 3. Good health; 03 medical and health sciences; Latin America; 0302 clinical medicine; Point-of-Care Testing; Prenatal Diagnosis; Income; Medicine; Humans; Mass Screening; Cost-effectiveness; Syphilis; Developing Countries; Research Article

Background Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. In low- and middle-income countries Asia Latin America, 20%-30% of women are not tested for during pregnancy. We evaluated cost-effectiveness increasing coverage antenatal screening 11 Asian 20 American countries, using a point-of-care immunochromatographic strip (ICS) test. Methods The decision analytical models reported incremental costs per disability-adjusted life years (DALYs) averted from perspectives national health care payer. Clinical were stillbirths, neonatal deaths, congenital syphilis. DALYs computed WHO disability weights. Costs included ICS test, three injections benzathine penicillin, nurse wages. Country-specific inputs prevalence proportion setting that screened infection as 2014 baseline report on global sexually transmitted surveillance. data annual number live births, at least one visit, capita gross income also model. Results cost/DALY US$53 (range: US$10-US$332; Prob<1*per GDP=99.71%) US$60 US$5-US$225; GDP=99.77%) America. Universal may reduce stillbirths by 20,344 4,270, deaths 8,201 1,721, cases 10,952 2,298, avert 925,039 197,454 aggregate panel, respectively. Conclusion Antenatal highly cost-effective all assessed. Our findings support expand currently low rates or continue programs high rates.