Evidence map›Paper›PMID 34310524›Full record

ArticleSexually transmitted diseases2022

Bridging the Gap Between Pilot and Scale-Up: A Model of Antenatal Testing for Curable Sexually Transmitted Infections From Botswana.

Adriane Wynn, Corrina Moucheraud, Natasha K Martin, Chelsea Morroni, Doreen Ramogola-Masire, Jeffrey D Klausner, Arleen Leibowitz

Open access · hybridAbstract read
In one paragraph

Article in Sexually transmitted diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 4 countries.

Adriane WynnFrom the Division of Infectious Diseases and Global Health, Department of Medicine, University of California, San Diego, La Jolla.
Corrina MoucheraudFielding School of Public Health, University of California, Los Angeles, Los Angeles, CA.
Natasha K MartinFrom the Division of Infectious Diseases and Global Health, Department of Medicine, University of California, San Diego, La Jolla.
Chelsea Morroni
Doreen Ramogola-MasireResearch and Graduate Studies, Faculty of Medicine, School of Medicine, University of Botswana, Gaborone, Botswana.
Jeffrey D KlausnerKeck School of Medicine.
Arleen LeibowitzSchool of Public Policy, University of California, Los Angeles, Los Angeles, CA.
University of California, Los Angeles · USUniversity of California San Diego · USUniversity of Botswana · BWWestern Cape Department of Health · ZA

Funding

UCLA Rapid, Relevant, Rigorous Implementation Science HubP30MH058107 · NIMH · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Nina Thawata Harawa · 1997 to 2026
$53.5M
University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
Training Program in Substance Use, HIV and Related InfectionsT32DA023356 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Natasha Martin, Steffanie A Strathdee · 2007 to 2026
$7.8M
Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modelingR01AI147490 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA · 2019 to 2022
$2.3M
Modeling reductions in harmful alcohol use on HIV transmission and mortality in the era of universal test and treat in UgandaK01AA027733 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI WYNN, ADRIANE MICHELLE · 2020 to 2024
$888k
The diagnosis and treatment of Chlamydia trachomatis and Neisseria gonorrhoeae in pregnant women to prevent adverse neonatal consequencesR21HD100821 · NICHD · UNIVERSITY OF SOUTHERN CALIFORNIA · PI KLAUSNER, JEFFREY DAVID, MORRONI, CHELSEA · 2020 to 2021
$398k
FIC NIH HHS D43 TW009343NIAAA NIH HHS K01 AA027733NIAID NIH HHS R01 AI147490NICHD NIH HHS L30 HD096686NICHD NIH HHS R21 HD100821NIDA NIH HHS T32 DA023356NIMH NIH HHS P30 MH058107
6 · The paper itself

Abstract

backgroundChlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are common sexually transmitted infections (STIs) associated with adverse outcomes, yet most countries do not test and conduct syndromic management, which lacks sensitivity and specificity. Innovations allow for expanded STI testing; however, cost is a barrier.

methodsUsing inputs from a pilot program in Botswana, we developed a model among a hypothetical population of 50,000 pregnant women to compare 1-year costs and outcomes associated with 3 antenatal STI testing strategies: (1) point-of-care, (2) centralized laboratory, and (3) a mixed approach (point of care at high-volume sites, and hubs elsewhere), and syndromic management.

resultsSyndromic management had the lowest delivery cost but was associated with the most infections at delivery, uninfected women treated, CT/NG-related low-birth-weight infants, disability-adjusted life years, and low birth weight hospitalization costs. Point-of-care CT/NG testing would treat and cure the most infections but had the highest delivery cost. Among the testing scenarios, the mixed scenario had the most favorable cost per woman treated and cured ($534/cure). Compared with syndromic management, the mixed approach resulted in a mean incremental cost-effectiveness ratio of $953 per disability-adjusted life years averted, which is cost-effective under World Health Organization's one-time per-capita gross domestic product willingness-to-pay threshold.

conclusionsAs countries consider new technologies to strengthen health services, there is an opportunity to determine how to best deploy resources. Compared with point-of-care, centralized laboratory, and syndromic management, the mixed approach offered the lowest cost per infection averted and is cost-effective if policy makers' willingness to pay is informed by the World Health Organization's gross domestic product/capita threshold.

Indexed as

Chlamydia InfectionsGonorrheaPregnancy Complications, InfectiousSexually Transmitted DiseasesBotswanaChlamydia trachomatisFemaleHumansNeisseria gonorrhoeaePregnancyPrevalence

Identifiers

PMID34310524
PMCPMC8663512
OpenAlexW3186159241

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.