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Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya

OBJECTIVE: This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. METHODS: A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy wit...

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Autores principales: Zimmermann, Marita R., Vodicka, Elisabeth, Babigumira, Joseph B., Okech, Timothy, Mugo, Nelly, Sakr, Samah, Garrison, Louis P., Chung, Michael H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513032/
https://www.ncbi.nlm.nih.gov/pubmed/28725164
http://dx.doi.org/10.1186/s12962-017-0075-6
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author Zimmermann, Marita R.
Vodicka, Elisabeth
Babigumira, Joseph B.
Okech, Timothy
Mugo, Nelly
Sakr, Samah
Garrison, Louis P.
Chung, Michael H.
author_facet Zimmermann, Marita R.
Vodicka, Elisabeth
Babigumira, Joseph B.
Okech, Timothy
Mugo, Nelly
Sakr, Samah
Garrison, Louis P.
Chung, Michael H.
author_sort Zimmermann, Marita R.
collection PubMed
description OBJECTIVE: This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. METHODS: A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. RESULTS: Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200–500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. CONCLUSIONS: Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit.
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spelling pubmed-55130322017-07-19 Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya Zimmermann, Marita R. Vodicka, Elisabeth Babigumira, Joseph B. Okech, Timothy Mugo, Nelly Sakr, Samah Garrison, Louis P. Chung, Michael H. Cost Eff Resour Alloc Research OBJECTIVE: This study evaluated the potential cost-effectiveness of cervical cancer screening in HIV treatment clinics in Nairobi, Kenya. METHODS: A Markov model was used to project health outcomes and costs of cervical cancer screening and cryotherapy at an HIV clinic in Kenya using cryotherapy without screening, visual inspection with acetic acid (VIA), Papanicolaou smear (Pap), and testing for human papillomavirus (HPV). Direct and indirect medical and non-medical costs were examined from societal and clinic perspectives. RESULTS: Costs of cryotherapy, VIA, Pap, and HPV for women with CD4 200–500 cells/mL were $99, $196, $219, and $223 from a societal perspective and $19, $94, $124, and $113 from a clinic perspective, with 17.3, 17.1, 17.1, and 17.1 years of life expectancy, respectively. Women at higher CD4 counts (>500 cells/mL) given cryotherapy VIA, Pap, and HPV resulted in better life expectancies (19.9+ years) and lower cost (societal: $49, $99, $115, and $102; clinic: $13, $51, $71, and $56). VIA was less expensive than HPV unless HPV screening could be reduced to a single visit. CONCLUSIONS: Preventative cryotherapy was the least expensive strategy and resulted in highest projected life expectancy, while VIA was most cost-effective unless HPV could be reduced to a single visit. BioMed Central 2017-07-14 /pmc/articles/PMC5513032/ /pubmed/28725164 http://dx.doi.org/10.1186/s12962-017-0075-6 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Zimmermann, Marita R.
Vodicka, Elisabeth
Babigumira, Joseph B.
Okech, Timothy
Mugo, Nelly
Sakr, Samah
Garrison, Louis P.
Chung, Michael H.
Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title_full Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title_fullStr Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title_full_unstemmed Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title_short Cost-effectiveness of cervical cancer screening and preventative cryotherapy at an HIV treatment clinic in Kenya
title_sort cost-effectiveness of cervical cancer screening and preventative cryotherapy at an hiv treatment clinic in kenya
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513032/
https://www.ncbi.nlm.nih.gov/pubmed/28725164
http://dx.doi.org/10.1186/s12962-017-0075-6
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