| Autor: |
Giuseppe Indolfi, Diana M Gibb, Sarah Pett, Yazdan Yazdanpanah, Sylvie Deuffic-Burban, Anthony E Ades, Karen Scott, Ali Judd, Nadia Hachicha-Maalej, Clotilde Lepers, Intira Jeannie Collins, Manal H El Sayed |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
BMJ Public Health, Vol 2, Iss 1 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2753-4294 |
| DOI: |
10.1136/bmjph-2023-000517 |
| Popis: |
Backgrounds and aims Pregnant women and children are not included in Egypt’s hepatitis C virus (HCV) elimination programmes. This study assesses the cost-effectiveness of several screening and treatment strategies for pregnant women and infants in Egypt.Design A Markov model was developed to simulate the cascade of care and HCV disease progression among pregnant women and their infants according to different screening and treatment strategies, which included: targeted versus universal antenatal screening; treatment of women in pregnancy or deferred till after breast feeding; treatment of infected children at 3 years vs 12 years. Current practice is targeted antenatal screening with deferred treatment for the mother and child. We also explored prophylactic treatment after birth for children of diagnosed HCV-infected women. Discounted lifetime cost, life expectancy (LE) and disability-adjusted life-years (DALYs) were calculated separately for women and their infants, and then combined.Results Current practice led to the highest cost (US$314.0), the lowest LE (46.3348 years) and the highest DALYs (0.0512 years) per mother–child pair. Universal screening and treatment during pregnancy followed by treatment of children at 3 years would be less expensive and more effective (cost saving) compared with current practice (US$219.3, 46.3525 and 0.0359 years). Prophylactic treatment at birth for infants born to HCV RNA-positive mothers would also be similarly cost saving, even with treatment uptake as low as 15% (US$218.6, 46.3525 and 0.0359 years). Findings were robust to reasonable changes in parameters.Conclusion Universal screening and treatment of HCV in pregnancy, with treatment of infected infants at age 3 years is cost saving compared with current practice in the Egyptian setting. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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