ArticleSexually transmitted infections2006
Modelling the cost-effectiveness of introducing rapid syphilis tests into an antenatal syphilis screening programme in Mwanza, Tanzania.
Article in Sexually transmitted infections, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- The cost-effectiveness of syphilis screening in pregnant women: a systematic literature review.Frontiers in public health · 2024Pooled it
- Pooled it
- Pooled it
- Genital inflammation screening for predicting sexually transmitted infections and bacterial vaginosis: an updated cost analysis from the GIFT study in Madagascar, South Africa, and Zimbabwe.BMC women's health · 2026Observational
- Point-of-care HIV and hepatitis screening in community pharmacies: a quantitative and qualitative study.International journal of clinical pharmacy · 2022Article
- Article
- Plasma Isolation in a Syringe by Conformal Integration of Inertial Microfluidics.Annals of biomedical engineering · 2021Article
- The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.PLoS neglected tropical diseases · 2017Article
- Cost-effectiveness of HIV and syphilis antenatal screening: a modelling study.Sexually transmitted infections · 2016Article
- Economic evaluations of interventions to reduce neonatal morbidity and mortality: a review of the evidence in LMICs and its implications for South Africa.Cost effectiveness and resource allocation : C/E · 2016Article
- Rapid Syphilis Testing Is Cost-Effective Even in Low-Prevalence Settings: The CISNE-PERU Experience.PloS one · 2016Article
- Screening for Sexually Transmitted Infections in Antenatal Care Is Especially Important Among HIV-Infected Women.Sexually transmitted diseases · 2015Article
- The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2015Article
- Article
- Article
- Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis.PLoS medicine · 2013Article
- Economic Evidence and Point-of-Care Testing.The Clinical biochemist. Reviews · 2013Review
- The development and validation of dried blood spots for external quality assurance of syphilis serology.BMC infectious diseases · 2013Article
- The impact of syphilis screening among female sex workers in China: a modelling study.PloS one · 2013Article
- Prioritizing congenital syphilis control in south China: a decision analytic model to inform policy implementation.PLoS medicine · 2013Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
Abstract
objectivesA study found screening (with rapid plasma reagin (RPR)) pregnant women for maternal syphilis was cost-effective in Mwanza, Tanzania. Recently, four rapid point-of-care (POC) syphilis tests were evaluated in Mwanza, and found to have reasonable sensitivity/specificity. This analysis estimates the relative cost-effectiveness of using these POC tests in the Mwanza syphilis screening intervention.
methodsEmpirical cost and epidemiological data were used to model the potential benefit of using POC tests instead of RPR. Reductions in costs relating to training, supplies, and equipment were estimated, and any changes in impact due to test sensitivity were included. Additional modelling explored how the results vary with prevalence of past infection, misclassified RPR results, and if not all women return for treatment.
resultsThe cost-effectiveness of using POC tests is mainly dependent on their cost and sensitivity for high titre active syphilis (HTAS). Savings due to reductions in training and equipment are small. Current POC tests may save more disability-adjusted life years (DALYs) than the RPR test in Mwanza, but the test cost needs to be <0.63 US dollars to be as cost-effective as RPR. However, the cost-effectiveness of the RPR test worsens by 15% if its HTAS sensitivity had been 75% instead of 86%, and by 25-65% if 20-40% of women had not returned for treatment. In such settings, POC tests could improve cost-effectiveness. Lastly, the cost-effectiveness of POC tests is affected little by the prevalence of syphilis, false RPR-positives, and past infections. DISCUSSION: Although the price of most POC tests needs to be reduced to make them as cost-effective as RPR, their simplicity and limited requirements for electricity/equipment suggest their use could improve the coverage of antenatal syphilis screening in developing countries.
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