Cost-effectiveness of rapid syphilis screening in prenatal HIV testing programs in Haiti
2007

Cost-Effectiveness of Rapid Syphilis Screening in Prenatal HIV Testing Programs in Haiti

publication Evidence: high

Author Information

Author(s): Bruce R. Schackman, Christopher P. Neukermans, Sandy N. Nerette Fontain, Claudine Nolte, Patrice Joseph, Jean W. Pape, Daniel W. Fitzgerald

Primary Institution: Weill Medical College, Cornell University

Hypothesis

Is integrating rapid syphilis testing into prenatal care cost-effective in preventing congenital syphilis and stillbirths in Haiti?

Conclusion

Integrating a new rapid syphilis test into prenatal care and HIV testing in Haiti would prevent congenital syphilis cases and stillbirths, and is cost-effective.

Supporting Evidence

  • Rapid testing with immediate treatment has a cost-effectiveness ratio of $6.83/DALY in rural settings and $9.95/DALY in urban settings.
  • Integrating rapid syphilis testing could prevent 1,125 congenital syphilis cases and 1,223 stillbirths or neonatal deaths annually.
  • The cost to prevent an adverse outcome of syphilis in pregnancy is $108–$218 per adverse outcome in rural settings.

Takeaway

This study shows that using quick tests for syphilis during pregnancy can help save babies' lives and is not too expensive.

Methodology

A decision analytic model was used to simulate health outcomes and costs for different syphilis screening strategies in rural and urban settings.

Limitations

The study's projections may not fully represent actual outcomes in Haiti, and the analysis did not account for potential consequences of widespread antibiotic use.

Participant Demographics

Pregnant women in rural and urban areas of Haiti.

Digital Object Identifier (DOI)

10.1371/journal.pmed.0040183

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