Analysis of the operational costs of using rapid syphilis tests for the detection of maternal syphilis in Bolivia and Mozambique.
OBJECTIVE
The objective of this study was to compare the costs of antenatal syphilis screening with the rapid plasma reagin (RPR) test and the immunochromatographic strip (ICS) test in low-resource settings.


OBJECTIVE
The goal of this study was to assess the costs of introducing rapid syphilis tests to reduce maternal and congenital syphilis.


METHODS
Cost data were collected from participating study hospitals and antenatal clinics during 4 field visits to the 2 countries in 2003 and 2004. Health utilization outcome data on the number of women screened and treated routinely during the demonstration projects were used with unit cost data to estimate the incremental costs and average cost per woman screened and treated for maternal syphilis.


RESULTS
In Mozambique, the average cost per woman screened was U.S. $0.91 and U.S. $1.05 for the RPR and ICS tests, respectively. In Bolivia, the average cost of screening was U.S. $1.48 and U.S. $1.91 using the RPR and ICS test, respectively. In health centers without laboratories, the cost per woman screened using the ICS test ranged from U.S. $1.02 in Mozambique to U.S. $2.84 in Bolivia.


CONCLUSIONS
It is feasible to introduce rapid syphilis testing in settings without laboratory services at a small incremental cost per woman screened. In settings with laboratories, the cost of ICS is similar to that of RPR.
Levin
Carol E
CE
PATH, 1455 NW Leary Way, Seattle, WA 98107, USA. clevin@path.org
Steele
Matthew
M
Atherly
Deborah
D
García
Sandra G
SG
Tinajeros
Freddy
F
Revollo
Rita
R
Richmond
Kara
K
Díaz-Olavarrieta
Claudia
C
Martin
Tom
T
Floriano
Florencia
F
Massango
Isabel
I
Gloyd
Stephen
S
D000554:Ambulatory Care Facilities; D001838:Bolivia / Q000453:epidemiology; D002845:Chromatography / Q000191:economics / Q000379:methods; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D007118:Immunoassay / Q000191:economics / Q000379:methods; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008403:Mass Screening / Q000191:economics / Q000379:methods; D009073:Mozambique / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D011296:Prenatal Diagnosis / Q000191:economics* / Q000706:statistics & numerical data*; D011933:Reagent Kits, Diagnostic / Q000191:economics / Q000706:statistics & numerical data; D011935:Reagins / Q000097:blood; D013587:Syphilis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D013590:Syphilis, Congenital / Q000517:prevention & control
D011933:Reagent Kits, Diagnostic; D011935:Reagins