title: Analysis of the operational costs of using rapid syphilis tests for the detection of maternal syphilis in Bolivia and Mozambique.
abstract: 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.
authors.affiliation: PATH, 1455 NW Leary Way, Seattle, WA 98107, USA. clevin@path.org
authors.forename: Carol E
authors.initials: CE
authors.lastname: Levin
authors.forename: Matthew
authors.initials: M
authors.lastname: Steele
authors.forename: Deborah
authors.initials: D
authors.lastname: Atherly
authors.forename: Sandra G
authors.initials: SG
authors.lastname: García
authors.forename: Freddy
authors.initials: F
authors.lastname: Tinajeros
authors.forename: Rita
authors.initials: R
authors.lastname: Revollo
authors.forename: Kara
authors.initials: K
authors.lastname: Richmond
authors.forename: Claudia
authors.initials: C
authors.lastname: Díaz-Olavarrieta
authors.forename: Tom
authors.initials: T
authors.lastname: Martin
authors.forename: Florencia
authors.initials: F
authors.lastname: Floriano
authors.forename: Isabel
authors.initials: I
authors.lastname: Massango
authors.forename: Stephen
authors.initials: S
authors.lastname: Gloyd
mesh_terms: 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
chemical_list: D011933:Reagent Kits, Diagnostic; D011935:Reagins