Cost effectiveness of facility and home based HIV voluntary counseling and testing strategies in rural Uganda
Cost effectiveness of facility and home based HIV voluntary counseling and testing strategies in rural Uganda
复制标题
DOI：
10.4314/ahs.v13i2.32
复制
发表时间：
2013-01-01
影响因子：
1
通讯作者：
Baine, O. S.
中科院分区：
文献类型：
--
作者：
Mulogo, E. M.;Batwala, V;Baine, O. S.
背景：在乌干达，提供人类免疫缺陷病毒(HIV)自愿咨询和检测(VCT)的主要场所是卫生机构。目的：评估在乌干达西南部农村地区基于设施和基于家庭的HIV VCT干预策略的成本效益。方法：收集乌干达西南部农村地区两个县关于基于设施和基于家庭的HIV VCT干预策略成本和效果的数据。使用配料法进行成本计算。有效性是通过确定艾滋病毒血清阳性客户的数量来衡量的。结果：设施VCT的每位受试者成本为6.4美元，家庭VCT为5.0美元。每例确诊阳性病例的相应成本分别为86.5美元和54.7美元。通过基于设施的VCT确定的每个额外阳性病例对提供者的增量成本为3.5美元。结论：基于家庭的VCT是每个受测对象成本最低的策略，并且在识别农村地区HIV血清阳性患者方面也具有成本效益。因此，应促进这一战略，以提高服务覆盖面，从而促进对符合治疗条件的客户的早期和广泛发现。
Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) has been at health facilities. Home based VCT on the other hand, was initiated in the country to improve service coverage.Objective: To evaluate the cost effectiveness of facility- and home-based HIV VCT strategies in rural southwestern Uganda.Methods: Data on costs and effectiveness of facility- and home-based HIV VCT intervention strategies was collected in two sub-Counties in rural southwestern Uganda. Costing was performed using the ingredients approach. Effectiveness was measured as the number of HIV sero-positive clients identified. Incremental Cost-Effectiveness Ratios (ICERs) were calculated from the provider perspective.Results: The cost per client tested were US$6.4 for facility based VCT and US$5.0 for home based VCT. The corresponding costs per positive case identified were US$86.5 and US$54.7 respectively. The incremental cost to providers per additional positive case identified by facility based VCT was US$3.5.Conclusion: Home based VCT was the least costly strategy per client tested and was also cost effective in identifying HIV sero-positive clients in rural areas. This strategy should therefore be promoted to improve service coverage and thereby facilitate early and extensive detection of clients eligible for treatment.