Costs and health consequences of chlamydia management strategies among pregnant women in sub-Saharan Africa.
Sex Transm Infect
; 83(7): 558-66, 2007 Dec.
Article
en En
| MEDLINE
| ID: mdl-17932126
ABSTRACT
OBJECTIVES:
Chlamydia is the most common bacterial sexually transmitted infection worldwide and a major cause of morbidity-particularly among women and neonates. We compared costs and health consequences of using point-of-care (POC) tests with current syndromic management among antenatal care attendees in sub-Saharan Africa. We also compared erythromycin with azithromycin treatment and universal with age-based chlamydia management.METHODS:
A decision analytical model was developed to compare diagnostic and treatment strategies, using Botswana as a case. Model input was based upon (1) a study of pregnant women in Botswana, (2) literature reviews and (3) expert opinion. We expressed the study outcome in terms of costs (US$), cases cured, magnitude of overtreatment and successful partner treatment.RESULTS:
Azithromycin was less costly and more effective than erythromycin. Compared with syndromic management, testing all attendees on their first visit with a 75% sensitive POC test increased the number of cases cured from 1500 to 3500 in a population of 100,000 women, at a cost of US$38 per additional case cured. This cost was lower in high-prevalence populations or if testing was restricted to teenagers. The specific POC tests provided the advantage of substantial reductions in overtreatment with antibiotics and improved partner management.CONCLUSIONS:
Using POC tests to diagnose chlamydia during antenatal care in sub-Saharan Africa entails greater health benefits than syndromic management does-and at acceptable costs-especially when restricted to younger women. Changes in diagnostic strategy and treatment regimens may improve people's health and even reduce healthcare budgets.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Complicaciones Infecciosas del Embarazo
/
Atención Prenatal
/
Infecciones por Chlamydia
/
Eritromicina
/
Azitromicina
/
Sistemas de Atención de Punto
/
Antibacterianos
Tipo de estudio:
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Pregnancy
País/Región como asunto:
Africa
Idioma:
En
Revista:
Sex Transm Infect
Asunto de la revista:
DOENCAS SEXUALMENTE TRANSMISSIVEIS
Año:
2007
Tipo del documento:
Article
País de afiliación:
Noruega