Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario.
Human visceral leishmaniasis (VL) is a severe and potentially fatal parasitic disease if not correctly diagnosed and treated. Brazil is one of the three countries most endemic for VL and, like most countries affected by this disease, has a large budget constraint for the incorporation of new health...
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ftdoajarticles:oai:doaj.org/article:415ede0af0984026bb3237863bbdc4ad 2023-05-15T15:16:25+02:00 Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. Mariana Lourenço Freire Aline de Souza Gláucia Cota Ana Rabello Tália Machado de Assis 2020-10-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008741 https://doaj.org/article/415ede0af0984026bb3237863bbdc4ad EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008741 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008741 https://doaj.org/article/415ede0af0984026bb3237863bbdc4ad PLoS Neglected Tropical Diseases, Vol 14, Iss 10, p e0008741 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008741 2022-12-31T10:07:30Z Human visceral leishmaniasis (VL) is a severe and potentially fatal parasitic disease if not correctly diagnosed and treated. Brazil is one of the three countries most endemic for VL and, like most countries affected by this disease, has a large budget constraint for the incorporation of new health technologies. Although different diagnostic tests for VL are currently available in the country, economic studies evaluating diagnostic kits are scarce. The objective of this study was to conduct a cost-effectiveness analysis of the nine available diagnostic tests for human VL in HIV-infected and uninfected patients in Brazil. The perspective of analysis was the Brazilian public health system, and the outcome of interest was "cases diagnosed correctly". The costs of the tests were estimated using the microcosting technique, and comparisons were performed with decision trees. Sensitivity analyses were explored applying variations in cost and effectiveness values. For VL diagnosis among HIV-uninfected patients, using blood samples for the rapid tests (RDTs), the noncommercial direct agglutination test (DAT-LPC) and IT-LEISH were cost-effective tests compared with the baseline OnSite test, but they presented different incremental cost-effectiveness ratios (ICER) of US$7.04 and US$ 205.40, respectively. Among HIV-infected patients, DAT-LPC was the most cost-effective diagnostic test. Comparisons among the tests with the same methodology, based on the low ICER values, revealed that IT-LEISH was the most cost-effective test among the RDTs and the Ridascreen Leishmania Ab among the ELISA tests. These results confirm that cost-effectiveness analyses can provide useful information to support the incorporation of new health technologies within a known scenario and willingness to pay threshold. It was observed that tests based on the same methodologies presented different cost-effectiveness ratios for the same group of patients and that different tests should be recommended for different patient groups. DAT-LPC was an important ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 10 e0008741 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Mariana Lourenço Freire Aline de Souza Gláucia Cota Ana Rabello Tália Machado de Assis Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Human visceral leishmaniasis (VL) is a severe and potentially fatal parasitic disease if not correctly diagnosed and treated. Brazil is one of the three countries most endemic for VL and, like most countries affected by this disease, has a large budget constraint for the incorporation of new health technologies. Although different diagnostic tests for VL are currently available in the country, economic studies evaluating diagnostic kits are scarce. The objective of this study was to conduct a cost-effectiveness analysis of the nine available diagnostic tests for human VL in HIV-infected and uninfected patients in Brazil. The perspective of analysis was the Brazilian public health system, and the outcome of interest was "cases diagnosed correctly". The costs of the tests were estimated using the microcosting technique, and comparisons were performed with decision trees. Sensitivity analyses were explored applying variations in cost and effectiveness values. For VL diagnosis among HIV-uninfected patients, using blood samples for the rapid tests (RDTs), the noncommercial direct agglutination test (DAT-LPC) and IT-LEISH were cost-effective tests compared with the baseline OnSite test, but they presented different incremental cost-effectiveness ratios (ICER) of US$7.04 and US$ 205.40, respectively. Among HIV-infected patients, DAT-LPC was the most cost-effective diagnostic test. Comparisons among the tests with the same methodology, based on the low ICER values, revealed that IT-LEISH was the most cost-effective test among the RDTs and the Ridascreen Leishmania Ab among the ELISA tests. These results confirm that cost-effectiveness analyses can provide useful information to support the incorporation of new health technologies within a known scenario and willingness to pay threshold. It was observed that tests based on the same methodologies presented different cost-effectiveness ratios for the same group of patients and that different tests should be recommended for different patient groups. DAT-LPC was an important ... |
format |
Article in Journal/Newspaper |
author |
Mariana Lourenço Freire Aline de Souza Gláucia Cota Ana Rabello Tália Machado de Assis |
author_facet |
Mariana Lourenço Freire Aline de Souza Gláucia Cota Ana Rabello Tália Machado de Assis |
author_sort |
Mariana Lourenço Freire |
title |
Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
title_short |
Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
title_full |
Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
title_fullStr |
Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
title_full_unstemmed |
Cost-effectiveness of serological tests for human visceral leishmaniasis in the Brazilian scenario. |
title_sort |
cost-effectiveness of serological tests for human visceral leishmaniasis in the brazilian scenario. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0008741 https://doaj.org/article/415ede0af0984026bb3237863bbdc4ad |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 10, p e0008741 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008741 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008741 https://doaj.org/article/415ede0af0984026bb3237863bbdc4ad |
op_doi |
https://doi.org/10.1371/journal.pntd.0008741 |
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PLOS Neglected Tropical Diseases |
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e0008741 |
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