ArticleSexually transmitted infections2016
Cost-effectiveness of HIV and syphilis antenatal screening: a modelling study.
Article in Sexually transmitted infections, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 6 of them syntheses that pooled it.
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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
28 citing papers in PubMed, 6 syntheses or guidelines pooled 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
- The costs of scaling up HIV and syphilis testing in low- and middle-income countries: a systematic review.Health policy and planning · 2021Pooled it
- The impact of antenatal syphilis point of care testing on pregnancy outcomes: A systematic review.PloS one · 2021Pooled it
- Pooled it
- A systematic review and meta-analysis of studies evaluating the performance and operational characteristics of dual point-of-care tests for HIV and syphilis.Sexually transmitted infections · 2017Pooled it
- Cost-effectiveness and cost-utility of antenatal sexually transmitted infection screening to reduce preterm birth and low birthweight in South Africa.medRxiv : the preprint server for health sciences · 2026Article
- Implementation and Innovation in Syphilis Diagnostics: Insights from Global Health Systems, Molecular Testing, and Self-Testing Strategies.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
- Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia.BMC infectious diseases · 2024Article
- The feasibility and impact of deploying a four-tests panel at antenatal care in primary health care facilities of a developing country, Kenya.Frontiers in public health · 2024Article
- Approaches to improving the efficiency of HIV programme investments.BMJ global health · 2022Article
- Point-of-Care Diagnostics for Diagnosis of Active Syphilis Infection: Needs, Challenges and the Way Forward.International journal of environmental research and public health · 2022Article
- Article
- Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.The Lancet. Global health · 2021Article
- Factors associated with HIV and syphilis screenings among pregnant women at first antenatal visit in Lusaka, Zambia.BMC research notes · 2020Article
- A clinical audit of maternal syphilis in a regional hospital in KwaZulu-Natal, South Africa.Southern African journal of infectious diseases · 2020Article
- Syphilis diagnosis and treatment during antenatal care: the potential catalytic impact of the dual HIV and syphilis rapid diagnostic test.The Lancet. Global health · 2019Article
- Assessing frontline HIV service provider efficiency using data envelopment analysis: a case study of Philippine social hygiene clinics (SHCs).BMC health services research · 2019Article
- Field evaluation of a dual rapid Human Immunodeficiency Virus and treponemal syphilis rapid test in community-based clinics in Los Angeles and New York.Diagnostic microbiology and infectious disease · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectivesThe WHO called for the elimination of maternal-to-child transmission (MTCT) of HIV and syphilis, a harmonised approach for the improvement of health outcomes for mothers and children. Testing early in pregnancy, treating seropositive pregnant women and preventing syphilis reinfection can prevent MTCT of HIV and syphilis. We assessed the health and economic outcomes of a dual testing strategy in a simulated cohort of 100 000 antenatal care patients in Malawi.
methodsWe compared four screening algorithms: (1) HIV rapid test only, (2) dual HIV and syphilis rapid tests, (3) single rapid tests for HIV and syphilis and (4) HIV rapid and syphilis laboratory tests. We calculated the expected number of adverse pregnancy outcomes, the expected costs and the expected newborn disability-adjusted life years (DALYs) for each screening algorithm. The estimated costs and DALYs for each screening algorithm were assessed from a societal perspective using Markov progression models. Additionally, we conducted a Monte Carlo multiway sensitivity analysis, allowing for ranges of inputs.
resultsOur cohort decision model predicted the lowest number of adverse pregnancy outcomes in the dual HIV and syphilis rapid test strategy. Additionally, from the societal perspective, the costs of prevention and care using a dual HIV and syphilis rapid testing strategy was both the least costly ($226.92 per pregnancy) and resulted in the fewest DALYs (116 639) per 100 000 pregnancies. In the Monte Carlo simulation the dual HIV and syphilis algorithm was always cost saving and almost always reduced DALYs compared with HIV testing alone.
conclusionsThe results of the cost-effectiveness analysis showed that a dual HIV and syphilis test was cost saving compared with all other screening strategies. Updating existing prevention of mother-to-child HIV transmission programmes in Malawi and similar countries to include dual rapid testing for HIV and syphilis is likely to be advantageous.
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