Economic evaluation of point-of-care testing and treatment for sexually transmitted and genital infections in pregnancy in low- and middle-income countries: A systematic review.
Economic evaluation of point-of-care testing and treatment for sexually transmitted and genital infections in pregnancy in low- and middle-income countries: A systematic review.
复制标题
DOI：
10.1371/journal.pone.0253135
复制
发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Wiseman V
中科院分区：
文献类型：
--
作者：
Saweri OPM;Batura N;Al Adawiyah R;Causer LM;Pomat WS;Vallely AJ;Wiseman V
妊娠期性传播和生殖器感染与不良妊娠和分娩结果有关。对这些感染的护理点检测有助于在一次产前诊所就诊中进行检测和治疗，并可能降低不良结果的风险。成功实施和扩大取决于了解这些方案的相对有效性及其相对成本和成本效益。本系统性综述综合和评估了来自低收入和中等收入国家孕妇性传播和生殖器感染的护理点检测和治疗的经济评价的证据。使用预先确定的标准全面检索Medline、Embase和Web of Science数据库。通过检索Google Scholar和所有纳入研究的参考书目确定了其他文献。如果经济评估是在低收入和中等收入国家进行的，并评估了梅毒、衣原体、淋病、滴虫病和/或细菌性阴道病的产前床旁检测和治疗，则符合条件。研究分析采用叙事综合。使用两份公布的核对表对方法和报告标准进行评估。本次审查包括16项经济评价; 10项在非洲，3项在拉丁美洲和南美洲，3项是跨大陆比较。15项研究评估了梅毒的即时检测和治疗，而一项研究评估了衣原体。成本和成本效益的主要驱动因素包括疾病流行率;检测、治疗和工作人员成本;检测灵敏度和特异性;以及筛查和治疗覆盖率。所有研究均符合Drummond清单标准的75%或以上，以及统一卫生经济学评价报告标准的60%。一般来说，与不进行筛查、综合征管理和实验室检测相比，即时检测和治疗具有成本效益。未来的经济评估应考虑其他常见感染及其对母亲和婴儿一生的影响。补充的负担能力和公平性分析将加强对产前护理点检测和性传播感染和生殖器感染治疗的投资。
Sexually transmitted and genital infections in pregnancy are associated with adverse pregnancy and birth outcomes. Point-of-care tests for these infections facilitate testing and treatment in a single antenatal clinic visit and may reduce the risk of adverse outcomes. Successful implementation and scale-up depends on understanding comparative effectiveness of such programmes and their comparative costs and cost effectiveness. This systematic review synthesises and appraises evidence from economic evaluations of point-of-care testing and treatment for sexually transmitted and genital infections among pregnant women in low- and middle-income countries. Medline, Embase and Web of Science databases were comprehensively searched using pre-determined criteria. Additional literature was identified by searching Google Scholar and the bibliographies of all included studies. Economic evaluations were eligible if they were set in low- and middle-income countries and assessed antenatal point-of-care testing and treatment for syphilis, chlamydia, gonorrhoea, trichomoniasis, and/or bacterial vaginosis. Studies were analysed using narrative synthesis. Methodological and reporting standards were assessed using two published checklists. Sixteen economic evaluations were included in this review; ten based in Africa, three in Latin and South America and three were cross-continent comparisons. Fifteen studies assessed point-of-care testing and treatment for syphilis, while one evaluated chlamydia. Key drivers of cost and cost-effectiveness included disease prevalence; test, treatment, and staff costs; test sensitivity and specificity; and screening and treatment coverage. All studies met 75% or more of the criteria of the Drummond Checklist and 60% of the Consolidated Health Economics Evaluation Reporting Standards. Generally, point-of-care testing and treatment was cost-effective compared to no screening, syndromic management, and laboratory-based testing. Future economic evaluations should consider other common infections, and their lifetime impact on mothers and babies. Complementary affordability and equity analyses would strengthen the case for greater investment in antenatal point-of-care testing and treatment for sexually transmitted and genital infections.
登录
查看更多内容
影响因子：
5.7
作者：
Gaydos C;Hardick J
通讯作者：
Hardick J
DOI：
10.1186/1478-7547-1-8
发表时间：
2003-12-19
期刊：
Cost effectiveness and resource allocation : C/E
影响因子：
--
作者：
Hutubessy, Raymond;Chisholm, Dan;Edejer, Tessa Tan-Torres
通讯作者：
Edejer, Tessa Tan-Torres
影响因子：
--
作者：
Byford, S;Raftery, J
通讯作者：
Raftery, J
影响因子：
5.4
作者：
Cookson, R.;Asaria, M.;Goldblatt, P.
通讯作者：
Goldblatt, P.
影响因子：
56.3
作者：
Drain, Paul K.;Hyle, Emily P.;Noubary, Farzad;Freedberg, Kenneth A.;Wilson, Douglas;Bishai, William R.;Rodriguez, William;Bassett, Ingrid V.
通讯作者：
Bassett, Ingrid V.