The costs of scaling up HIV and syphilis testing in low- and middle-income countries: a systematic review.
The costs of scaling up HIV and syphilis testing in low- and middle-income countries: a systematic review.
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DOI：
10.1093/heapol/czab030
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发表时间：
2021-06-25
影响因子：
3.2
通讯作者：
Wiseman V
中科院分区：
文献类型：
--
作者：
Adawiyah RA;Saweri OPM;Boettiger DC;Applegate TL;Probandari A;Guy R;Guinness L;Wiseman V
大约三分之二的艾滋病毒新感染病例和90%的梅毒病例发生在低收入和中等收入国家(LMIC)。检测是预防和治疗艾滋病毒和梅毒的关键战略。在扩大艾滋病毒和梅毒检测的成本方面，LMIC的决策者面临着相当大的不确定性。这篇论文综合了关于扩大艾滋病毒和梅毒检测干预措施成本的经济证据，以及关于成本如何随着提供规模的变化而变化的证据。我们系统地搜索了多个数据库(Medline、Econlitt、Embase、EmCare、CINAHL、Global Health和NHS经济评估数据库)，以进行同行评议的研究，检查在LMIC中扩大艾滋病毒和梅毒检测的成本。从4869条独特引文中确定了35项符合条件的研究。大多数研究是在撒哈拉以南非洲地区进行的(N = 17)，大多数研究探讨了针对普通人群的设施中快速艾滋病毒感染的成本(N = 19)。只有两项研究专注于梅毒检测。17项研究是成本分析，17项是成本效益分析，1项是艾滋病毒或梅毒检测的成本效益分析。大多数研究采用建模方法(N = 25)，并假设成本随规模线性增加。十项研究考察了与规模相关的成本效率，大多数研究报告了短期规模经济。扩大规模的成本的重要驱动因素包括测试吸收和测试套件的价格。扩大检测的“真正”成本很可能被短期决策框架、线性单位成本预测(即将平均成本乘以反映更大规模活动的系数)以及卫生系统监督和支持扩大检测的能力和基础设施的可用性所掩盖。随着艾滋病毒和梅毒检测在LMIC继续扩大，需要与其他监测指标一起定期收集成本数据。
Around two-thirds of all new HIV infections and 90% of syphilis cases occur in low- and middle-income countries (LMICs). Testing is a key strategy for the prevention and treatment of HIV and syphilis. Decision-makers in LMICs face considerable uncertainties about the costs of scaling up HIV and syphilis testing. This paper synthesizes economic evidence on the costs of scaling up HIV and syphilis testing interventions in LMICs and evidence on how costs change with the scale of delivery. We systematically searched multiple databases (Medline, Econlit, Embase, EMCARE, CINAHL, Global Health and the NHS Economic Evaluation Database) for peer-reviewed studies examining the costs of scaling up HIV and syphilis testing in LMICs. Thirty-five eligible studies were identified from 4869 unique citations. Most studies were conducted in Sub-Saharan Africa (N = 17) and most explored the costs of rapid HIV in facilities targeted the general population (N = 19). Only two studies focused on syphilis testing. Seventeen studies were cost analyses, 17 were cost-effectiveness analyses and 1 was cost–benefit analysis of HIV or syphilis testing. Most studies took a modelling approach (N = 25) and assumed costs increased linearly with scale. Ten studies examined cost efficiencies associated with scale, most reporting short-run economies of scale. Important drivers of the costs of scaling up included testing uptake and the price of test kits. The ‘true’ cost of scaling up testing is likely to be masked by the use of short-term decision frameworks, linear unit-cost projections (i.e. multiplying an average cost by a factor reflecting activity at a larger scale) and availability of health system capacity and infrastructure to supervise and support scale up. Cost data need to be routinely collected alongside other monitoring indicators as HIV and syphilis testing continues to be scaled up in LMICs.
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影响因子：
2.8
作者：
Cherutich P;Farquhar C;Wamuti B;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Bukusi D;Levin C;aPS Study Group
通讯作者：
aPS Study Group
影响因子：
2.1
作者：
Johns, B;Baltussen, R
通讯作者：
Baltussen, R
影响因子：
6
作者：
Ishikawa, Naoko;Dalal, Shona;Baggaley, Rachel
通讯作者：
Baggaley, Rachel
影响因子：
6
作者：
Asiimwe, Stephen;Ross, Jennifer M.;Barnabas, Ruanne V.
通讯作者：
Barnabas, Ruanne V.
DOI：
10.1093/infdis/jiv040
发表时间：
2015-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Cambiano V;Ford D;Mabugu T;Napierala Mavedzenge S;Miners A;Mugurungi O;Nakagawa F;Revill P;Phillips A
通讯作者：
Phillips A