ArticleThe Lancet. Global health2021
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Article in The Lancet. Global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Benefits and harms of antenatal and newborn screening programmes in health economic assessments: the VALENTIA systematic review and qualitative investigation.Health technology assessment (Winchester, England) · 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
- Missed opportunities for HIV testing among those who accessed sexually transmitted infection (STI) services, tested for STIs and diagnosed with STIs: a systematic review and meta-analysis.Journal of the International AIDS Society · 2023Pooled it
- Rapid/point-of-care syphilis testing in high-income countries: insights and implementation challenges from the authors' experience in Canada.Journal of clinical microbiology · 2026Review
- 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
- The Global Syphilis Epidemic: Turning the Tide.Sexually transmitted diseases · 2026Article
- Congenital Syphilis Elimination in Latin America: A Systematic Analysis of Policy and Progress.Sexually transmitted diseases · 2026Article
- Successes and setbacks in dual HIV/syphilis test scale-up strategies: Lessons learned for testing integration in an era of declining resources.Health policy OPEN · 2026Article
- Progress towards the elimination of vertical transmission of HIV, syphilis and hepatitis B in 21 high-burden countries.Journal of the International AIDS Society · 2026Review
- Political prioritization of prevention of mother-to-child transmission of HIV and syphilis: a qualitative comparative policy analysis in Ghana, Mozambique, and Sudan.Frontiers in public health · 2026Article
- Opportunities to Optimize Outcomes of Diagnosis and Treatment of HIV and Syphilis in Pregnancy: the Quest to Eliminate Maternal and Vertical Transmission.Current HIV/AIDS reports · 2025Review
- Cost-effectiveness of integrated maternal HIV, syphilis, and hepatitis B screening opt-out strategies in Nepal: a modelling study.The Lancet regional health. Southeast Asia · 2025Article
- 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
- External quality assessment to support the WHO ProSPeRo study for the evaluation of two dual HIV/syphilis point-of-care tests in seven countries.BMC infectious diseases · 2024Article
- Syphilis prevalence and correlates of infection among Venezuelan refugees and migrants in Colombia: findings of a cross-sectional biobehavioral survey.Lancet regional health. Americas · 2024Article
- HIV Infection and Associated Factors Among Out-of-School MSM Aged 16-24 Years - 6 Cities and Tianjin Municipality, China, 2022-2023.China CDC weekly · 2024Article
- Article
- Evaluating the performance of a risk assessment score tool to predict HIV acquisition among pregnant and postpartum women in Kenya.PloS one · 2024Article
- Article
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Authors and funding
19 authors at 8 institutions in 7 countries.
Funding
Abstract
backgroundDual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. We aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence.
methodsIn this modelling study, we developed Markov models of HIV and syphilis in pregnant women to estimate costs and infant health outcomes of maternal testing at the first antenatal care visit with individual HIV and syphilis tests (base case) and at the first antenatal care visit with a dual rapid diagnostic test (scenario one). We additionally evaluated retesting during late antenatal care and at delivery with either individual tests (scenario two) or a dual rapid diagnosis test (scenario three). We modelled four countries: South Africa, Kenya, Colombia, and Ukraine. Strategies with an incremental cost-effectiveness ratio (ICER) less than the country-specific cost-effectiveness threshold (US$500 in Kenya, $750 in South Africa, $3000 in Colombia, and $1000 in Ukraine) per disability-adjusted life-year averted were considered cost-effective.
findingsRoutinely offering testing at the first antenatal care visit with a dual rapid diagnosis test was cost-saving compared with the base case in all four countries (ICER: -$26 in Kenya,-$559 in South Africa, -$844 in Colombia, and -$454 in Ukraine). Retesting during late antenatal care with a dual rapid diagnostic test (scenario three) was cost-effective compared with scenario one in all four countries (ICER: $270 in Kenya, $260 in South Africa, $2207 in Colombia, and $205 in Ukraine).
interpretationIncorporating dual rapid diagnostic tests in antenatal care can be cost-saving across countries with varying HIV prevalence. Countries should consider incorporating dual HIV and syphilis rapid diagnostic tests as the first test in antenatal care to support efforts to eliminate MTCT of HIV and syphilis.
fundingWHO, US Agency for International Development, and the Bill & Melinda Gates Foundation.
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