Cost effectiveness of cryptococcal antigen screening as a strategy to prevent HIV-associated cryptococcal meningitis in South Africa

Cryptococcal meningitis (CM)-related mortality may be prevented by screening patients for sub-clinical cryptococcal antigenaemia (CRAG) at antiretroviral-therapy (ART) initiation and pre-emptively treating those testing positive. Prior to programmatic implementation in South Africa we performed a co...

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Bibliographic Details
Published in:PloS one 2013-07, Vol.8 (7), p.e69288-e69288
Main Authors: Jarvis, Joseph N, Harrison, Thomas S, Lawn, Stephen D, Meintjes, Graeme, Wood, Robin, Cleary, Susan
Format: Article
Language:English
Subjects:
Acquired immune deficiency syndrome
AIDS
AIDS-Related Opportunistic Infections - diagnosis
AIDS-Related Opportunistic Infections - economics
Analysis
Antigens
Antigens, Fungal - immunology
Antiretroviral agents
Antiretroviral drugs
CD4 antigen
Central nervous system
Cost analysis
Cost benefit analysis
Cost effectiveness
Cryptococcus neoformans - immunology
Disease control
Disease prevention
Drug dosages
Drug resistance
Drug therapy
Economic aspects
Fluconazole
Fungal infections
Health aspects
Health Care Costs
Health economics
HIV
Human immunodeficiency virus
Humans
Immunoassay
Infections
Infectious diseases
Markov Chains
Mass Screening - economics
Medicine
Meningitis
Meningitis, Cryptococcal - diagnosis
Meningitis, Cryptococcal - economics
Models, Statistical
Mortality
Patient Outcome Assessment
Patients
Prevention
Prophylaxis
Screening
Social and Behavioral Sciences
South Africa
Strategy
Therapy
Tropical diseases
Tutu, Desmond
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Description
Summary:Cryptococcal meningitis (CM)-related mortality may be prevented by screening patients for sub-clinical cryptococcal antigenaemia (CRAG) at antiretroviral-therapy (ART) initiation and pre-emptively treating those testing positive. Prior to programmatic implementation in South Africa we performed a cost-effectiveness analysis of alternative preventive strategies for CM. Cost-effectiveness analysis. Using South African data we modelled the cost-effectiveness of four strategies for patients with CD4 cell-counts
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0069288