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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Cost-effectiveness of HIV screening of blood donations in Accra (Ghana)
Value in Health, Volume 11, No. 5, Year 2008
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Description
Objectives: Areas with high HIV-incidence rates compared to the developed world may benefit from additional testing in blood banks and may show more favorable cost-effectiveness ratios. We evaluated the cost-effectiveness of adding p24 antigen, mini pool nucleic acid amplification testing (MP-NAT), or individual donation NAT (ID-NAT) to the HIV-antibody screening at the Korle Bu Teaching Hospital (Accra, Ghana), where currently only HIV-antibody screening is undertaken. Methods: The residual risk of HIV transmission was derived from blood donations to the blood bank of the Korle Bu Teaching Hospital in 2004. Remaining life expectancies of patients receiving blood transfusion were estimated using the World Health Organization life expectancies. Cost-effectiveness ratios for adding the tests to HIV-antibody screening only were determined using a decision tree model and a Markov model for HIV. Results: The prevalence of HIV was estimated at 1.51% in 18,714 donations during 2004. The incremental cost per disability-adjusted life-year (DALY) averted was US$1237 for p24 antigen, US$3142 for MP-NAT and US$7695 compared to the next least expensive strategy. HIV-antibody screening itself was cost-saving compared to no screening at all, gaining US$73.85 and averting 0.86 DALY per transfused patient. Up to a willingness-to-pay of US$2736 per DALY averted, HIV-antibody screening without additional testing was the most cost-effective strategy. Over a willingness-to-pay of US$11,828 per DALY averted, ID-NAT was significantly more cost-effective than the other strategies. Conclusions: Adding p24 antigen, MP-NAT, or ID-NAT to the current antibody screening cannot be regarded as a cost-effective health-care intervention for Ghana. © 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
Authors & Co-Authors
van Hulst, Marinus V.D.
Netherlands, Groningen
Rijksuniversiteit Groningen
Netherlands, Groningen
Martini Ziekenhuis
Sagoe, Kwamena William Coleman
Ghana, Accra
University of Ghana
Vermande, Jacobien E.
Netherlands, Groningen
Rijksuniversiteit Groningen
Van Der Schaaf, Ido P.
Netherlands, Groningen
Rijksuniversiteit Groningen
Netherlands, Amsterdam
Vrije Universiteit Amsterdam Athena Instituut
Van Der Tuuk Adriani, Willem P.A.
Netherlands, Groningen
Sanquin Consulting Services
Torpey, Kwasi E.
United States, Durham
Fhi 360
Ansah, Justina
Ghana, Accra
National Blood Service
Mingle, Julius Abraham Addo
Ghana, Accra
University of Ghana
Sibinga, Cees T.Smit
Netherlands, Groningen
Sanquin Consulting Services
Postma, Maarten Jacobus
Netherlands, Groningen
Rijksuniversiteit Groningen
Statistics
Citations: 10
Authors: 10
Affiliations: 7
Identifiers
Doi:
10.1111/j.1524-4733.2008.00337.x
ISSN:
10983015
e-ISSN:
15244733
Research Areas
Disability
Health System And Policy
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study
Study Locations
Ghana