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Finding a Needle in the Haystack: The Costs and Cost-Effectiveness of Syphilis Diagnosis and Treatment during Pregnancy to Prevent Congenital Syphilis in Kalomo District of Zambia

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  • Bruce A Larson
  • Deophine Lembela-Bwalya
  • Rachael Bonawitz
  • Emily E Hammond
  • Donald M Thea
  • Julie Herlihy

Abstract

Background: In March 2012, The Elizabeth Glaser Pediatric AIDS Foundation trained maternal and child health workers in Southern Province of Zambia to use a new rapid syphilis test (RST) during routine antenatal care. A recent study by Bonawitz et al. (2014) evaluated the impact of this roll out in Kalomo District. This paper estimates the costs and cost-effectiveness from the provider's perspective under the actual conditions observed during the first year of the RST roll out. Methods: Information on materials used and costs were extracted from program records. A decision-analytic model was used to evaluate the costs (2012 USD) and cost-effectiveness. Basic parameters needed for the model were based on the results from the evaluation study. Results: During the evaluation study, 62% of patients received a RST, and 2.8% of patients tested were positive (and 10.4% of these were treated). Even with very high RST sensitivity and specificity (98%), true prevalence of active syphilis would be substantially less (estimated at

Suggested Citation

  • Bruce A Larson & Deophine Lembela-Bwalya & Rachael Bonawitz & Emily E Hammond & Donald M Thea & Julie Herlihy, 2014. "Finding a Needle in the Haystack: The Costs and Cost-Effectiveness of Syphilis Diagnosis and Treatment during Pregnancy to Prevent Congenital Syphilis in Kalomo District of Zambia," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-17, December.
    • Handle: RePEc:plo:pone00:0113868
    DOI: 10.1371/journal.pone.0113868
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    References listed on IDEAS

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    1. Andreas Kuznik & Mohammed Lamorde & Agnes Nyabigambo & Yukari C Manabe, 2013. "Antenatal Syphilis Screening Using Point-of-Care Testing in Sub-Saharan African Countries: A Cost-Effectiveness Analysis," PLOS Medicine, Public Library of Science, vol. 10(11), pages 1-15, November.
    2. Bruce R Schackman & Christopher P Neukermans & Sandy N Nerette Fontain & Claudine Nolte & Patrice Joseph & Jean W Pape & Daniel W Fitzgerald, 2007. "Cost-Effectiveness of Rapid Syphilis Screening in Prenatal HIV Testing Programs in Haiti," PLOS Medicine, Public Library of Science, vol. 4(5), pages 1-11, May.
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    Cited by:

    1. Patricia Mallma & Patricia Garcia & Cesar Carcamo & Sergio Torres-Rueda & Rosanna Peeling & David Mabey & Fern Terris-Prestholt, 2016. "Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-11, March.

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