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International Journal of STD & AIDS

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Int J STD AIDS 2008;19:393-399
doi:10.1258/ijsa.2007.007272
© 2008 Royal Society of Medicine Press

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Original research articles

Cost effectiveness of enzyme immunoassay and immunoblot testing for the diagnosis of syphilis

Anderson Chuck PhD {dagger}, Arto Ohinmaa PhD * {dagger}, Peter Tilley MD {ddagger} , Ameeta Singh BMBS MSc § and Philip Jacobs DPhil * {dagger}

* Department of Public Health Sciences, University of Alberta; {dagger} Institute of Health Economics, Edmonton; {ddagger} Provincial Laboratory for Public Health, Calgary; § Provincial Health Office, Alberta Health and Wellness, Edmonton, Alberta, Canada

Correspondence to: Dr Peter Tilley, Provincial Laboratory for Public Health, 3030 Hospital Drive NW, Calgary, Alberta, Canada T2N 4W4 Email: p.tilley{at}provlab.ab.ca

The burden of disease and associated health-care costs of syphilis are significant despite widespread screening and treatment. Our objective was to conduct an economic evaluation using a simulation model when comparing enzyme immunoassay (EIA) initial testing and Inno-Lia (IL) confirmatory testing (EIA + IL) with rapid plasma reagin (RPR) initial testing and Treponema pallidum particle agglutination assay (TPPA) and fluorescent treponemal antibody absorption assay (FTA-ABS) confirmatory testing (RPR + TPPA/FTA). Estimates of prevalence, test costs and utilization of services for 2006 were derived from Alberta databases. Estimates of test characteristics were derived from the available literature. The incremental cost-effectiveness ratio was Canadian $461 per additional correct diagnosis (less costly and more effective). EIA + IL is cost-effective when compared with RPR + TPPA/FTA for screening and diagnosis of syphilis.

Key Words: syphilis • cost-effectiveness analysis • testing • screening • economics


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