Evidence map›Paper›PMID 37525192›Full record

ArticleBMC health services research2023

Economic analysis of a new four-panel rapid screening test in antenatal care in Kenya, Rwanda, and Uganda.

Donald S Shepard, Yara A Halasa-Rappel, Katharine R Rowlands, Maria Kulchyckyj, Robert K Basaza, Emmanuel D Otieno, Boniface Mutatina, Simon Kariuki, Sabine F Musange

Abstract read
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Donald S ShepardThe Heller School for Social Policy & Management, Brandeis University, Waltham, MA, 02454-9110, USA. shepard@brandeis.edu.
Yara A Halasa-RappelThe Heller School for Social Policy & Management, Brandeis University, Waltham, MA, 02454-9110, USA.
Katharine R RowlandsThe Heller School for Social Policy & Management, Brandeis University, Waltham, MA, 02454-9110, USA.
Maria KulchyckyjThe Heller School for Social Policy & Management, Brandeis University, Waltham, MA, 02454-9110, USA.
Robert K BasazaUganda Christian University, Mukono, Uganda.
Emmanuel D OtienoBugema University, Bugema, Uganda.
Boniface MutatinaMakerere University School of Medicine, Kampala, Uganda.
Simon KariukiKenya Medical Research Institute, Kisian, Kenya.
Sabine F MusangeUniversity of Rwanda, Kigali, Rwanda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe performed an economic analysis of a new technology used in antenatal care (ANC) clinics, the ANC panel. Introduced in 2019-2020 in five Rwandan districts, the ANC panel screens for four infections [hepatitis B virus (HBV), human immunodeficiency virus (HIV), malaria, and syphilis] using blood from a single fingerstick. It increases the scope and sensitivity of screening over conventional testing.

methodsWe developed and applied an Excel-based economic and epidemiologic model to perform cost-effectiveness and cost-benefit analyses of this technology in Kenya, Rwanda, and Uganda. Costs include the ANC panel itself, its administration, and follow-up treatment. Effectiveness models predicted impacts on maternal and infant mortality and other outcomes. Key parameters are the baseline prevalence of each infection and the effectiveness of early treatment using observations from the Rwanda pilot, national and international literature, and expert opinion. For each parameter, we found the best estimate (with 95% confidence bound).

resultsThe ANC panel averted 92 (69-115) disability-adjusted life years (DALYs) per 1,000 pregnant women in ANC in Kenya, 54 (52-57) in Rwanda, and 258 (156-360) in Uganda. Net healthcare costs per woman ranged from $0.53 ($0.02-$4.21) in Kenya, $1.77 ($1.23-$5.60) in Rwanda, and negative $5.01 (-$6.45 to $0.48) in Uganda. Incremental cost-effectiveness ratios (ICERs) in dollars per DALY averted were $5.76 (-$3.50-$11.13) in Kenya, $32.62 ($17.54-$46.70) in Rwanda, and negative $19.40 (-$24.18 to -$15.42) in Uganda. Benefit-cost ratios were $17.48 ($15.90-$23.71) in Kenya, $6.20 ($5.91-$6.45) in Rwanda, and $25.36 ($16.88-$33.14) in Uganda. All results appear very favorable and cost-saving in Uganda.

conclusionThough subject to uncertainty, even our lowest estimates were still favorable. By combining field data and literature, the ANC model could be applied to other countries.

Indexed as

Health Care CostsPrenatal CareCost-Benefit AnalysisFemaleHumansInfantKenyaPregnancyRwandaUgandaAntenatal careCost-effectivenessHepatitis BHIV/AIDSKenyaMalariaRwandaSyphilisUganda

Identifiers

PMID37525192
PMCPMC10391856

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.