Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe.
Costs of facility-based HIV testing in Malawi, Zambia and Zimbabwe.
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DOI：
10.1371/journal.pone.0185740
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Terris-Prestholt F
中科院分区：
文献类型：
--
作者：
Mwenge L;Sande L;Mangenah C;Ahmed N;Kanema S;d'Elbée M;Sibanda E;Kalua T;Ncube G;Johnson CC;Hatzold K;Cowan FM;Corbett EL;Ayles H;Maheswaran H;Terris-Prestholt F
在保健设施提供艾滋病毒检测仍然是确保撒哈拉以南非洲数百万未确诊的艾滋病毒感染者获得艾滋病毒治疗和预防服务的最常见办法。我们试图探索在三个艾滋病毒负担较高的南部非洲国家提供这些服务的成本。在马拉维、赞比亚和津巴布韦的54个提供艾滋病毒检测服务(HTS)的卫生机构进行了初步成本研究。对卫生设施例行收集的监测和评价数据进行了提取，以估算每名接受检查的个人的费用和确定的每名艾滋病毒阳性个人的费用。费用以2016美元列示。敏感度分析探讨了成本的关键驱动因素。卫生机构每年平均对2290人进行测试，尽管差异很大。马拉维、赞比亚和津巴布韦的人均检测费用分别为5.03.9美元、4.24美元和8.79美元。在马拉维、赞比亚和津巴布韦，每个确认的艾滋病毒阳性个体的平均成本分别为79.58亿美元、73.63万美元和178.92美元。这两种成本估计都对检测规模、设施人员水平和艾滋病毒检测试剂盒的成本敏感。以卫生设施为基础的艾滋病毒检测仍然是实现艾滋病毒普及目标的一项基本服务。低成本和规模经济的潜力意味着进一步扩大规模的机会。然而，许多情况下的低接纳率表明，可能需要创造需求或替代测试模式，以实现规模经济，并接触到不太愿意接受基于设施的服务的人群。
Providing HIV testing at health facilities remains the most common approach to ensuring access to HIV treatment and prevention services for the millions of undiagnosed HIV-infected individuals in sub-Saharan Africa. We sought to explore the costs of providing these services across three southern African countries with high HIV burden. Primary costing studies were undertaken in 54 health facilities providing HIV testing services (HTS) in Malawi, Zambia and Zimbabwe. Routinely collected monitoring and evaluation data for the health facilities were extracted to estimate the costs per individual tested and costs per HIV-positive individual identified. Costs are presented in 2016 US dollars. Sensitivity analysis explored key drivers of costs. Health facilities were testing on average 2290 individuals annually, albeit with wide variations. The mean cost per individual tested was US$5.03.9 in Malawi, US$4.24 in Zambia and US$8.79 in Zimbabwe. The mean cost per HIV-positive individual identified was US$79.58, US$73.63 and US$178.92 in Malawi, Zambia and Zimbabwe respectively. Both cost estimates were sensitive to scale of testing, facility staffing levels and the costs of HIV test kits. Health facility based HIV testing remains an essential service to meet HIV universal access goals. The low costs and potential for economies of scale suggests an opportunity for further scale-up. However low uptake in many settings suggests that demand creation or alternative testing models may be needed to achieve economies of scale and reach populations less willing to attend facility based services.
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影响因子：
3.6
作者：
Kalichman, SC;Simbayi, LC
通讯作者：
Simbayi, LC
影响因子：
5.4
作者：
Angotti, Nicole;Bula, Agatha;Yeatman, Sara E.
通讯作者：
Yeatman, Sara E.
影响因子：
168.9
作者：
Granich, Reuben M.;Gilks, Charles F.;Williams, Brian G.
通讯作者：
Williams, Brian G.
影响因子：
15.8
作者：
Johnson LF;Mossong J;Dorrington RE;Schomaker M;Hoffmann CJ;Keiser O;Fox MP;Wood R;Prozesky H;Giddy J;Garone DB;Cornell M;Egger M;Boulle A;International Epidemiologic Databases to Evaluate AIDS Southern Africa Collaboration
通讯作者：
International Epidemiologic Databases to Evaluate AIDS Southern Africa Collaboration
影响因子：
3.2
作者：
Kumaranayake, L
通讯作者：
Kumaranayake, L