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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

AFRICA: Syphilis Screening and Treatment in Pregnancy May be Cost-Effective in Sub-Saharan Africa


Medical Xpress (11.05.2013) Aids Weekly Plus

An article in Medical Xpress reported on a study of the cost effectiveness of syphilis screening and treatment in pregnant women in sub-Saharan Africa. Mohammed Lamorde of Uganda’s Makerere College of Health Sciences and colleagues at Pfizer and Johns Hopkins School of Medicine in the United States investigated whether screening pregnant women for syphilis using the immunochromatographic strip (ICS) point-of-care tests, and treatment with benzathine penicillin would be a cost-efficient method of decreasing congenital syphilis, which has serious consequences such as stillbirth and birth defects. The researchers created a model using data from 43 countries in sub-Saharan Africa to determine if the benefits of universal screening and treatment of pregnant women at prenatal visits would outweigh financial costs to countries with limited resources. Findings showed that at the present syphilis prevalence rates, testing and treatment could prevent approximately 25,000 newborn deaths and 64,000 stillbirths in the region annually. After considering the effects of syphilis on surviving babies, the researchers found that screening and treatment could prevent 2.6 million disability-adjusted life years (DALYs). Cost of screening and treatment varied in different countries, but the average cost of each DALY prevented was only $11, much lower than the costs of preventing transmission to children. The researchers suggested improving cost efficiency by combining prevention of mother-to-child transmission of HIV and syphilis. The researchers concluded that use of ICS tests for prenatal syphilis screening is highly cost-effective in sub-Saharan Africa. The full report, “Antenatal Syphilis Screening Using Point-of-Care Testing in Sub-Saharan African Countries: A Cost-Effectiveness Analysis.” was published in the journal PLoS Med (2013; doi: 10.1371/journal.pmed.1001545).


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