Cost-effectiveness of treatment strategies for cervical infection among women at high risk in Madagascar.

Journal Article (Journal Article)

BACKGROUND: According to the national guidelines developed in 2001, a woman at high risk of gonorrhea and chlamydia in Madagascar is treated presumptively at her first sexually transmitted infection clinic visit; risk-based treatment (RB) is subsequently used at 3-month visits. OBJECTIVES: To compare health and economic outcomes for a 2-stage Markov process with the following 3 cervical infection treatment policies at baseline and at 3-month follow-up visit: presumptive treatment (PT), RB, and an interim laboratory/risk-based policy. STUDY DESIGN: Cost-effectiveness analysis was used to compare the 9 treatment strategies. RESULTS: When 3-month incidence of cervical infection is <20%, the national guidelines are less costly and less effective than both RB followed by PT, and PT at both visits. CONCLUSIONS: The national guidelines are a reasonable strategy, especially in the context of resource constraints, relatively low reinfection rates, and local preferences.

Full Text

Duke Authors

Cited Authors

  • McClamroch, K; Behets, F; Van Damme, K; Rabenja, LN; Myers, E

Published Date

  • September 2007

Published In

Volume / Issue

  • 34 / 9

Start / End Page

  • 631 - 637

PubMed ID

  • 17308503

International Standard Serial Number (ISSN)

  • 0148-5717

Digital Object Identifier (DOI)

  • 10.1097/01.olq.0000258107.75888.0e


  • eng

Conference Location

  • United States