The cost-effectiveness of parasitologic diagnosis for malaria-suspected patients in an era of combination therapy
The cost-effectiveness of parasitologic diagnosis for malaria-suspected patients in an era of combination therapy
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DOI：
10.4269/ajtmh.2007.77.128
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发表时间：
2007-12-01
影响因子：
3.3
通讯作者：
Mills, Anne
中科院分区：
文献类型：
--
作者：
Lubell, Yoel;Revburn, Hugh;Mills, Anne
在撒哈拉以南非洲采用青蒿素类复方疗法，促使人们呼吁更多地使用寄生虫学诊断方法来诊断疟疾。我们评估了成本效益的快速诊断测试（RDTs）相比，显微镜在指导治疗非严重发热性疾病在不同程度的疟疾流行使用的测试准确性和成本的数据收集的坦桑尼亚试验的一部分。如果开处方者遵守现行指南，显微镜检查在高传播和低传播地区的每例正确治疗患者的平均费用将低于RDT。RDT的引入将导致额外的2.3%和9.4%的患者得到正确治疗，在低和高传播环境中分别增加25美元和7美元的成本。如果开处方者不遵守测试结果，成本效益会更差。这一额外好处的成本可能高于许多国家在没有外部援助或RDT价格较低的情况下所能承受的水平。
The introduction of artemisinin-based combination therapy in sub-Saharan Africa has prompted calls for increased use of parasitologic diagnosis for malaria. We evaluated the cost-effectiveness of rapid diagnostic tests (RDTs) in comparison to microscopy in guiding treatment of non-severe febrile illness at varying levels of malaria endemicity using data on test accuracy and costs collected as part of a Tanzanian trial. If prescribers complied with current Guidelines, microscopy would give rise to lower average costs per patient correctly treated than RDTs in areas of both high and low transmission. RDT introduction would result in an additional 2.3% and 9.4% of patients correctly treated, at an incremental cost of $25 and $7 in the low and high transmission settings, respectively. Cost-effectiveness would be worse if prescribers do not comply with test results. The cost of this additional benefit may be higher than many countries can afford without external assistance or lower RDT prices.