Sexually Transmitted Diseases

Skip Navigation LinksHome > July 2007 - Volume 34 - Issue 7 > Cost-Effectiveness of On-Site Antenatal Screening to Prevent...
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Sexually Transmitted Diseases:
doi: 10.1097/01.olq.0000258314.20752.5f

Cost-Effectiveness of On-Site Antenatal Screening to Prevent Congenital Syphilis in Rural Eastern Cape Province, Republic of South Africa

Blandford, John M. PhD*; Gift, Thomas L. PhD*; Vasaikar, Sandeep PhD†; Mwesigwa-Kayongo, Dan MD†; Dlali, Pumla MS†; Bronzan, Rachel N. MD*

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Objectives: On-site screening and same-day treatment of maternal syphilis in underresourced settings can avert greater numbers of congenital syphilis cases, but health outcomes and associated costs must be evaluated jointly.

Methods: We used decision analysis to estimate the incremental cost-effectiveness of two on-site antenatal syphilis screening strategies to avert congenital infections—qualitative RPR (on-site RPR) and treponemal immunochromatographic strip assay (on-site ICS)—compared to the current practice (off-site RPR/TPHA).

Findings: With antenatal active syphilis prevalence of 6.3%, the incremental cost-effectiveness of on-site ICS in averting congenital infections was estimated to be USD104, averting 82% of cases expected in absence of a program. The incremental cost-effectiveness of off-site RPR/TPHA was USD82 but would avert only 55% of congenital syphilis cases. On-site RPR was dominated by the other screening strategies.

Conclusions: In settings of high maternal syphilis prevalence, on-site antenatal screening with ICS is a cost-effective approach to reduce the incidence of congenital syphilis.

© Copyright 2007 American Sexually Transmitted Diseases Association


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