ArticleInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2015
The cost-effectiveness of 10 antenatal syphilis screening and treatment approaches in Peru, Tanzania, and Zambia.
Article in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Health technology assessment to support health benefits package design: a systematic review of economic evaluation evidence in Zambia.BMC health services research · 2024Pooled it
- Ignored and undervalued in public health: a systematic review of health state utility values associated with syphilis infection.Health and quality of life outcomes · 2024Pooled it
- The cost-effectiveness of syphilis screening in pregnant women: a systematic literature review.Frontiers in public health · 2024Pooled it
- Pooled it
- Metaanalysis of the Performance of a Combined Treponemal and Nontreponemal Rapid Diagnostic Test for Syphilis and Yaws.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Pooled it
- A comparative analysis of costs of single and dual rapid HIV and syphilis diagnostics: results from a randomised controlled trial in Colombia.Sexually transmitted infections · 2017Trial
- Introducing onsite antenatal syphilis screening in Burkina Faso: implementation and evaluation of a feasibility intervention tailored to a local context.BMC health services research · 2017Trial
- Estimating the Value of Novel Tests for Active Syphilis in Zimbabwe: How Much Overtreatment Can Be Avoided?Sexually transmitted diseases · 2026Article
- The Potential for Combined Treponemal/Nontreponemal Rapid Point-of-Care Test and Treponema pallidum Polymerase Chain Reaction in the Diagnosis of Gestational and Congenital Syphilis in a Low-Resource, High-Prevalence Setting: Pilot Data From Malawi.Sexually transmitted diseases · 2026Article
- 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
- Article
- Syphilis and pregnancy.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2024Article
- Article
- Using a dual antibody point-of-care test with visual and digital reads to diagnose syphilis among people living with HIV in Botswana.International journal of STD & AIDS · 2021Article
- Toward Improving Accessibility of Point-of-Care Diagnostic Services for Maternal and Child Health in Low- and Middle-Income Countries.Point of care · 2019Article
- Point-of-care tests for syphilis and yaws in a low-income setting - A qualitative study of healthcare worker and patient experiences.PLoS neglected tropical diseases · 2018Article
- Prevention of Congenital Syphilis Through Antenatal Screenings in Lusaka, Zambia: A Systematic Review.Cureus · 2018Review
- Comparison of RPR and ELISA with TPHA for the Diagnosis of Syphilis: Implication for Updating Syphilis Point-of-Care Tests in Ethiopia.Journal of immunology research · 2018Article
- The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.PLoS neglected tropical diseases · 2017Article
- The introduction of syphilis point of care tests in resource limited settings.Expert review of molecular diagnostics · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 8 institutions in 6 countries.
Funding
Abstract
objectiveRapid plasma reagin (RPR) is frequently used to test women for maternal syphilis. Rapid syphilis immunochromatographic strip tests detecting only Treponema pallidum antibodies (single RSTs) or both treponemal and non-treponemal antibodies (dual RSTs) are now available. This study assessed the cost-effectiveness of algorithms using these tests to screen pregnant women.
methodsObserved costs of maternal syphilis screening and treatment using clinic-based RPR and single RSTs in 20 clinics across Peru, Tanzania, and Zambia were used to model the cost-effectiveness of algorithms using combinations of RPR, single, and dual RSTs, and no and mass treatment. Sensitivity analyses determined drivers of key results.
resultsAlthough this analysis found screening using RPR to be relatively cheap, most (>70%) true cases went untreated. Algorithms using single RSTs were the most cost-effective in all observed settings, followed by dual RSTs, which became the most cost-effective if dual RST costs were halved. Single test algorithms dominated most sequential testing algorithms, although sequential algorithms reduced overtreatment. Mass treatment was relatively cheap and effective in the absence of screening supplies, though treated many uninfected women.
conclusionThis analysis highlights the advantages of introducing RSTs in three diverse settings. The results should be applicable to other similar settings.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.