Objective: To estimate the incremental cost-effectiveness of universal vs. test-directed treatment of latent tuberculous infection (LTBI) among human immunodeficiency virus (HIV) positive pregnant women in South Africa.
Methods: We compared tuberculin skin test (TST) directed isoniazid preventive therapy (IPT) (TST placement with delivery of IPT to women with positive results) against QuantiFERON-TB Gold In-Tube (QGIT) directed IPT and universal IPT using decision analysis. Costs were measured empirically in six primary care public health clinics in Matlosana, South Africa. The primary outcome was the incremental cost-effectiveness ratio, expressed in 2016 US$ per disability-adjusted life-year (DALY) averted.
Results: We estimated that 29.2 of every 1000 pregnant women would develop TB over the course of 1 year in the absence of IPT. TST-directed IPT reduced this number to 24.5 vs. 22.6 with QGIT-directed IPT and 21.0 with universal IPT. Universal IPT was estimated to cost $640/DALY averted (95% uncertainty range $44-$3146) relative to TST-directed IPT and was less costly and more effective (i.e., dominant) than QGIT-directed IPT. Cost-effectiveness was most sensitive to the probability of developing TB and LTBI prevalence.
Conclusion: Providing IPT to all eligible women can be a cost-effective strategy to prevent TB among HIV-positive pregnant women in South Africa.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635914 | PMC |
| http://dx.doi.org/10.5588/ijtld.18.0370 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The implication of pericardial effusion in the third trimester for preeclampsia and heart failure in high-risk pregnant women.
J Echocardiogr
January 2025
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 1035 Dalgubeol-Daero, Dalseo-Gu, Daegu, 42601, Republic of Korea.
Background: With the growing number of high-risk pregnant women, echocardiography frequently reveals pericardial effusion (PE). However, the clinical implications of PE are unknown.
Method: We analyzed a cohort of 406 high-risk pregnant women who underwent echocardiography in the third trimester between November 2019 and December 2022.
A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity.
BMC Pregnancy Childbirth
January 2025
Department of Gynecology and Obstetrics, Reina Sofía Hospital, Tudela, Spain.
Background: There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the effects of exercise, compared with usual care, in reducing GDM and other obstetric risks, in overweight and obese pregnant women.
View Article and Find Full Text PDFMicronutrient dose response (MiNDR) study among women of reproductive age and pregnant women in rural Bangladesh: study protocol for double-blind, randomised, controlled trials.
BMJ Open
January 2025
Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Introduction: Optimising the micronutrient status of women before and during reproduction confers benefits to them and their offspring. Antenatal multiple micronutrient supplements (MMS), given as a daily tablet with nutrients at ~1 recommended dietary allowance (RDA) or adequate intake (AI) reduces adverse birth outcomes. However, at this dosage, MMS may not fully address micronutrient deficiencies in settings with chronically inadequate diets and infection.
View Article and Find Full Text PDFDigital health technologies enabling the transition from pregnancy to early parenthood: A scoping review.
Z Evid Fortbild Qual Gesundhwes
January 2025
Department Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, Siegen, Germany.
Background: Pregnant women and their families, especially those navigating chronic illness or challenging life situations, often seek information and counseling. The pregnancy period and the transition to parenthood can exacerbate these circumstances, leaving families particularly vulnerable. Addressing stressful situations becomes a hurdle in this context.
View Article and Find Full Text PDFReadability, quality and accuracy of generative artificial intelligence chatbots for commonly asked questions about labor epidurals: a comparison of ChatGPT and Bard.
Int J Obstet Anesth
December 2024
Department of Anesthesiology, 8700 Beverly Blvd #4209, Cedars-Sinai Medical Center, Los Angeles, CA 90064, United States. Electronic address:
Introduction: Over 90% of pregnant women and 76% expectant fathers search for pregnancy health information. We examined readability, accuracy and quality of answers to common obstetric anesthesia questions from the popular generative artificial intelligence (AI) chatbots ChatGPT and Bard.
Methods: Twenty questions for generative AI chatbots were derived from frequently asked questions based on professional society, hospital and consumer websites.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!