Is antenatal syphilis screening still cost effective in sub-Saharan Africa


Terris-Prestholt, F; Watson-Jones, D; Mugeye, K; Kumaranayake, L; Ndeki, L; Weiss, H; Changalucha, J; Todd, J; Lisekie, F; Gumodoka, B; Mabey, D; Hayes, R; (2003) Is antenatal syphilis screening still cost effective in sub-Saharan Africa. Sexually transmitted infections, 79 (5). pp. 375-81. ISSN 1368-4973 DOI: 10.1136/sti.79.5.375

Full text not available from this repository. (Request a copy)

Abstract

OBJECTIVES: To estimate the cost effectiveness of on-site antenatal syphilis screening and treatment in Mwanza, Tanzania. To compare this intervention with other antenatal and child health interventions, specifically the prevention of mother to child transmission of HIV (PMTCT). METHODS: The economic costs of adding the intervention to routine antenatal care were assessed. Cost effectiveness (CE) ratios of the intervention were obtained for low birth weight (LBW) live births and stillbirths averted and cost per DALY saved. Cost per DALY saved was also estimated for previous CE studies of syphilis screening. The CE of the intervention at different syphilis prevalence rates was modelled. RESULTS: The economic cost of the intervention is $1.44 per woman screened, $20 per woman treated, and $187 per adverse birth outcome averted. The cost per DALY saved is $110 with LBW as the only adverse outcome. When including stillbirth, this estimate improves 10-fold to $10.56 per DALY saved. The cost per DALY saved from all syphilis screening studies ranged from $3.97 to $18.73. CONCLUSIONS: Syphilis screening is shown to be at least as cost effective as PMTCT and more cost effective than many widely implemented interventions. There is urgent need for scaling up syphilis screening and treatment in high prevalence areas. The CE of screening interventions is highly dependent on disease prevalence. In combination, PMTCT and syphilis screening and treatment interventions may achieve economies of scope and thus improved efficiency.

Item Type: Article
Keywords: birth-weight, demonstration project, child survival, pregnancy, mortality, tanzania, prevention, transmission, disability, infants
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Public Health and Policy > Dept of Global Health and Development
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Population Studies (1974-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Tropical Epidemiology Group
Malaria Centre
Social and Mathematical Epidemiology (SaME)
SaME Modelling & Economics
Population Studies Group
PubMed ID: 14573832
Web of Science ID: 186110900007
URI: http://researchonline.lshtm.ac.uk/id/eprint/15802

Statistics


Download activity - last 12 months
Downloads since deposit
0Downloads
352Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item