| Author | Romero Casas, Carmen Nila Phang | |
| Author | Marinho, Daniel Savignon | |
| Author | Castro, Rodolfo | |
| Author | Pereira, Claudia Cristina de Aguiar | |
| Author | Silva, Everton Nunes da | |
| Author | Caetano, Rosângela | |
| Author | Elias, Flávia Tavares Silva | |
| Author | Chilcott, James | |
| Author | Dixon, Simon | |
| Access date | 2021-06-25T12:57:29Z | |
| Available date | 2021-06-25T12:57:29Z | |
| Document date | 2020 | |
| Citation | ROMERO, Carmen Phang et al. Cost-effectiveness analysis of point-of-care rapid testing versus laboratory-based testing for antenatal screening of Syphilis in Brazil. Value in Health Regional, [s.l.], v. 23, p. 61-69, Dec. 2020. | pt_BR |
| ISSN | 2212-1099 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/47865 | |
| Language | eng | pt_BR |
| Publisher | Elsevier | pt_BR |
| Rights | open access | pt_BR |
| MeSH | Pregnant Women | pt_BR |
| MeSH | Syphilis | pt_BR |
| MeSH | Diagnostic Tests Routine | pt_BR |
| Title | Cost-effectiveness analysis of point-of-care rapid testing versus laboratory-based testing for antenatal screening of Syphilis in Brazil | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1016/j.vhri.2020.03.004 | |
| Abstract | Objectives: Severe consequences of mother-to-child transmission of syphilis and high increasing incidence of congenital syphilis remains an important public health problem in Brazil. Our objective was to assess the cost-effectiveness of a rapid point-of-care test (RT) and treatment of positive mothers immediately compared with a laboratory-based standard test (ST) with treatment at next follow-up visit. Methods: A decision analytic model was developed to estimate the incremental cost-effectiveness ratio (ICER) between antenatal syphilis screening strategies. The model was built with lifetime horizon from Brazilian health system perspective using 3% and 5% discount rates. A hypothetical cohort of pregnant women at reproductive age were used in the model. Health outcomes: low birth weight, stillbirths, neonatal deaths and congenital syphilis were estimated in disability-adjusted life-years (DALYs) lost. Microcosting study and secondary data provided parameters of direct medical costs. Probabilistic sensitivity analysis was undertaken. Results: For base case, the mean cost per pregnant woman screened was $2.63 (RT) and $2.48 (ST), respectively. Maternal syphilis was associated with a loss of 0.0043 DALYs (RT) and 0.0048 DALYs (ST) per mother screened. Expected value of incremental cost per DALY averted was $298.08. After 10 000 probabilistic sensitivity analysis model runs, incremental cost and health benefits were $0.15 (95% credible interval –1.56 to 1.92) and 0.00042 DALYs (95% credible interval –0.0036 to 0.0044), respectively, with a mean ICER of $357.44 per DALY. Screening with RT has a 58% chance of being the optimal strategy at a threshold of $3,200 per DALY. Conclusions: In Brazil, antenatal screening with syphilis RT and immediate treatment is likely to be cost-effective compared with standard screening and must be prioritized in local settings. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Centro de desenvolvimento Tecnológico em Saúde. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Conselho Nacional de Desenvolvimento Científico e Tecnológico. Instituto Nacional de Ciência e Tecnologia de Inovação em Doenças de Populações Negligenciadas. Brasília, DF, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Estado do Rio de Janeiro. Instituto de Saúde Coletiva. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Universidade de Brasília. Brasília, DF, Brasil. | pt_BR |
| Affilliation | Universidade Federal do Estado do Rio de Janeiro. Rio de Janeiro, RJ, Brasil. | pt_BR |
| Affilliation | Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. | pt_BR |
| Affilliation | University of Sheffield. School of Health and Related Research. Sheffield, England, United kingdom. | pt_BR |
| Subject | Cost-effectiveness | pt_BR |
| Subject | Maternal syphilis | pt_BR |
| Subject | Pregnant women | pt_BR |
| Subject | Rapid test | pt_BR |
| Subject | Syphilis screening | pt_BR |
| DeCS | Análise Custo-Benefício | pt_BR |
| DeCS | Testes Diagnósticos de Rotina | pt_BR |
| DeCS | Sífilis | pt_BR |
| DeCS | Gestantes | pt_BR |
