Cost-effectiveness of using a rapid diagnostic test to screen for human African trypanosomiasis in the Democratic Republic of the Congo.
Cost-effectiveness of using a rapid diagnostic test to screen for human African trypanosomiasis in the Democratic Republic of the Congo.
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DOI：
10.1371/journal.pone.0204335
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Ndung'u JM
中科院分区：
文献类型：
--
作者：
Bessell PR;Lumbala C;Lutumba P;Baloji S;Biéler S;Ndung'u JM
用于筛查非洲人类锥虫病（HAT）的新的快速诊断试验（RDTs）已被引入，作为锥虫病卡凝集试验（CATT）的替代方法。其中一种RDT， SD BIOLINE HAT RDT已被证明比CATT具有更低的特异性但更高的敏感性，因此在筛选策略之间做出合理选择，成本-效果分析是关键因素。在本文中，我们估计了当在刚果民主共和国（DRC）实施CATT和RDT时的相对成本效益。有关流行病学参数和费用的数据是作为一项更大研究的一部分收集的。这些数据被用于对流动医疗队和固定卫生机构的三种不同诊断算法进行建模，并以每个诊断病例的平均成本来衡量相对成本效益。在固定设施和流动小组中，使用SD BIOLINE HAT RDT进行参与者筛选，然后进行寄生虫学确认，其成本-效果比使用CATT的算法低。与使用CATT的算法相比，使用RDT的算法在移动团队和固定卫生机构诊断的每例病例分别便宜112.54（33.2%）和88.54（32.92%）美元。敏感性分析表明，这些结论对许多假设都是可靠的，并且结果可以扩展到更小或更大的设施，以及一系列的患病率。在所有实际情况下，RDT是最具成本效益的筛查试验，并且比CATT检测到更多病例。因此，在此基础上，SD BIOLINE HAT RDT可被认为是刚果民主共和国用于HAT常规筛查的最具成本效益的选择。
New rapid diagnostic tests (RDTs) for screening human African trypanosomiasis (HAT) have been introduced as alternatives to the card agglutination test for trypanosomiasis (CATT). One brand of RDT, the SD BIOLINE HAT RDT has been shown to have lower specificity but higher sensitivity than CATT, so to make a rational choice between screening strategies, a cost-effectiveness analysis is a key element. In this paper we estimate the relative cost-effectiveness of CATT and the RDT when implemented in the Democratic Republic of the Congo (DRC). Data on the epidemiological parameters and costs were collected as part of a larger study. These data were used to model three different diagnostic algorithms in mobile teams and fixed health facilities, and the relative cost-effectiveness was measured as the average cost per case diagnosed. In both fixed facilities and mobile teams, screening of participants using the SD BIOLINE HAT RDT followed by parasitological confirmation had a lower cost-effectiveness ratio than in algorithms using CATT. Algorithms using the RDT were cheaper by 112.54 (33.2%) and 88.54 (32.92%) US dollars per case diagnosed in mobile teams and fixed health facilities respectively, when compared with algorithms using CATT. Sensitivity analysis demonstrated that these conclusions were robust to a number of assumptions, and that the results can be scaled to smaller or larger facilities, and a range of prevalences. The RDT was the most cost-effective screening test in all realistic scenarios and detected more cases than CATT. Thus, on this basis, the SD BIOLINE HAT RDT could be considered as the most cost-effective option for use in routine screening for HAT in the DRC.
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影响因子：
3.8
作者：
Hasker E;Lutumba P;Chappuis F;Kande V;Potet J;De Weggheleire A;Kambo C;Depoortere E;Pécoul B;Boelaert M
通讯作者：
Boelaert M
影响因子：
3.3
作者：
Lutumba, P;Robays, J;Boelaert, M
通讯作者：
Boelaert, M
影响因子：
3.8
作者：
Holmes, Peter
通讯作者：
Holmes, Peter
影响因子：
4.5
作者：
Husereau, Don;Drummond, Michael;Loder, Elizabeth
通讯作者：
Loder, Elizabeth
影响因子：
3.8
作者：
Jamonneau V;Camara O;Ilboudo H;Peylhard M;Koffi M;Sakande H;N'Dri L;Sanou D;Dama E;Camara M;Lejon V
通讯作者：
Lejon V