Sedona Sweeney1, Jacklin F Mosha2, Fern Terris-Prestholt2, Kimberly A Sollis2, Helen Kelly2, John Changalucha2, Rosanna W Peeling2. 1. London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, National Institute for Medical Research, Mwanza Tanzania and London School of Hygiene and Tropical Medicine, Keppel Street, WCIE 7HT, London sedona.sweeney@lshtm.ac.uk. 2. London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, WC1H 9SH, London, National Institute for Medical Research, Mwanza Tanzania and London School of Hygiene and Tropical Medicine, Keppel Street, WCIE 7HT, London.
Abstract
OBJECTIVES: To determine the costs of Rapid Syphilis Test (RSTs) as compared with rapid plasma reagin (RPR) when implemented in a Tanzanian setting, and to determine the relative impact of a quality assurance (QA) system on the cost of RST implementation. METHODS: The incremental costs for RPR and RST screening programmes in existing antenatal care settings in Geita District, Tanzania were collected for 9 months in subsequent years from nine health facilities that varied in size, remoteness and scope of antenatal services. The costs per woman tested and treated were estimated for each facility. A sensitivity analysis was constructed to determine the impact of parameter and model uncertainty. FINDINGS: In surveyed facilities, a total of 6362 women were tested with RSTs compared with 224 tested with RPR. The range of unit costs was $1.76-$3.13 per woman screened and $12.88-$32.67 per woman treated. Unit costs for the QA system came to $0.51 per woman tested, of which 50% were attributed to salaries and transport for project personnel. CONCLUSIONS: Our results suggest that rapid syphilis diagnostics are very inexpensive in this setting and can overcome some critical barriers to ensuring universal access to syphilis testing and treatment. The additional costs for implementation of a quality system were found to be relatively small, and could be reduced through alterations to the programme design. Given the potential for a quality system to improve quality of diagnosis and care, we recommend that QA activities be incorporated into RST roll-out. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
OBJECTIVES: To determine the costs of Rapid Syphilis Test (RSTs) as compared with rapid plasma reagin (RPR) when implemented in a Tanzanian setting, and to determine the relative impact of a quality assurance (QA) system on the cost of RST implementation. METHODS: The incremental costs for RPR and RST screening programmes in existing antenatal care settings in Geita District, Tanzania were collected for 9 months in subsequent years from nine health facilities that varied in size, remoteness and scope of antenatal services. The costs per woman tested and treated were estimated for each facility. A sensitivity analysis was constructed to determine the impact of parameter and model uncertainty. FINDINGS: In surveyed facilities, a total of 6362 women were tested with RSTs compared with 224 tested with RPR. The range of unit costs was $1.76-$3.13 per woman screened and $12.88-$32.67 per woman treated. Unit costs for the QA system came to $0.51 per woman tested, of which 50% were attributed to salaries and transport for project personnel. CONCLUSIONS: Our results suggest that rapid syphilis diagnostics are very inexpensive in this setting and can overcome some critical barriers to ensuring universal access to syphilis testing and treatment. The additional costs for implementation of a quality system were found to be relatively small, and could be reduced through alterations to the programme design. Given the potential for a quality system to improve quality of diagnosis and care, we recommend that QA activities be incorporated into RST roll-out. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine
Authors: Katharine D Shelley; Éimhín M Ansbro; Alexander Tshaka Ncube; Sedona Sweeney; Colette Fleischer; Grace Tembo Mumba; Michelle M Gill; Susan Strasser; Rosanna W Peeling; Fern Terris-Prestholt Journal: PLoS One Date: 2015-05-13 Impact factor: 3.240
Authors: Éimhín M Ansbro; Michelle M Gill; Joanna Reynolds; Katharine D Shelley; Susan Strasser; Tabitha Sripipatana; Alexander Tshaka Ncube; Grace Tembo Mumba; Fern Terris-Prestholt; Rosanna W Peeling; David Mabey Journal: PLoS One Date: 2015-06-01 Impact factor: 3.240
Authors: Adrienne F A Meyers; Paul Sandstrom; Thomas N Denny; Mackenzie Hurlston; Terry B Ball; Rosanna W Peeling; Debrah I Boeras Journal: Afr J Lab Med Date: 2016-10-17
Authors: Kevin J Land; Debrah I Boeras; Xiang-Sheng Chen; Andrew R Ramsay; Rosanna W Peeling Journal: Nat Microbiol Date: 2018-12-13 Impact factor: 17.745
Authors: Rabiah Al Adawiyah; Olga P M Saweri; David C Boettiger; Tanya L Applegate; Ari Probandari; Rebecca Guy; Lorna Guinness; Virginia Wiseman Journal: Health Policy Plan Date: 2021-06-25 Impact factor: 3.344
Authors: Olga P M Saweri; Neha Batura; Rabiah Al Adawiyah; Louise M Causer; William S Pomat; Andrew J Vallely; Virginia Wiseman Journal: PLoS One Date: 2021-06-17 Impact factor: 3.240