Advanced Search
MyIDEAS: Login

Costs and health consequences of chlamydia management strategies among pregnant women in sub-Saharan Africa

Contents:

Author Info

  • Romoen, Maria

    (Faculty of Medicine)

  • Sundby, Johanne

    (Faculty of Medicine)

  • Hjortdahl, Per

    (Faculty of Medicine)

  • Hussein, Fatrima

    (Ministry of Health)

  • Steen, Tore W.

    (Ministry of Health)

  • Velauthapillai, Manonmany

    (Ministry of Health)

  • Kristiansen, Ivar Sønbø

    ()
    (Institute of Health Management and Health Economics)

Registered author(s):

    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 analytic 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 was erythromycin. Compared to syndromic management, testing all attendees on their first visit with a 75% sensitive POC test increased the number of cases cured from 1 500 to 3 500 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 health care budgets.

    Download Info

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
    File URL: http://www.hero.uio.no/publicat/2007/HERO2007_10.pdf
    Download Restriction: no

    Bibliographic Info

    Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2007:10.

    as in new window
    Length: 103 pages
    Date of creation: 03 Jun 2009
    Date of revision:
    Handle: RePEc:hhs:oslohe:2007_010

    Contact details of provider:
    Postal: HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway
    Phone: 2307 5309
    Fax: 2307 5310
    Email:
    Web page: http://www.hero.uio.no/eng.html
    More information through EDIRC

    Related research

    Keywords: Chlamydia trachomatis (MeSH); Cost-effectiveness analysis (non-MeSH); Cost Analysis (MeSH); Developing countries (MeSH); Africa (MeSH); Sub-Saharan Africa (MeSH) Maternal health (non-MeSH); Maternal Health Services (MeSH); Women’s Health (MeSH); Point-of-care tests (non-MeSH); Diagnostic tests (non-MeSH); Diagnosis (MeSH); Syndromic approach (non-MeSH); STI management (non-MeSH);

    Find related papers by JEL classification:

    This paper has been announced in the following NEP Reports:

    References

    No references listed on IDEAS
    You can help add them by filling out this form.

    Citations

    Lists

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    Statistics

    Access and download statistics

    Corrections

    When requesting a correction, please mention this item's handle: RePEc:hhs:oslohe:2007_010. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Anbjørg Kolaas).

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.