Objective: To assess the cost-effectiveness of prenatal detection of congenital cytomegalovirus (cCMV) following maternal primary infection in the first trimester within standard pregnancy follow-up or involving population-based screening (serological testing at 7 and 12 weeks of gestation), with or without secondary prevention (valaciclovir) in maternal CMV primary infection.
Design: Cost-effectiveness study from the perspective of the French national health insurance system.
Setting: Cost-effectiveness based on previously published probability estimates and associated plausible ranges hypothetical population of 1,000,000 pregnant women.
Population: Hypothetical population of 1,000,000 pregnant women.
Methods: Cost-effectiveness of detecting fetal cCMV in terms of the total direct medical costs involved and associated expected outcomes.
Main Outcome Measures: Detection rates and clinical outcomes at birth.
Results: Moving to a population-based approach for targeting fetal CMV infections would generate high monetary and organizational costs while increasing detection rates from 15% to 94%. This resource allocation would help implementing horizontal equity according to which individuals with similar medical needs should be treated equally. Secondary prevention with valaciclovir had a significant effect on maternal-fetal CMV transmission and clinical outcomes in newborns, with a 58% decrease of severely infected newborns for a 3.5% additional total costs. Accounting for women decision-making (amniocentesis uptake and termination of pregnancy in severe cases) did not impact the cost-effectiveness results.
Conclusions: These findings could fuel thinking on the opportunity of developing clinical guidelines to rule identification of cCMV infection and administration of in-utero treatment. These findings could fuel the development of clinical guidelines on the identification of congenital CMV infection and the administration of treatment in utero.
Tweetable Abstract: CMV serological screening followed by valaciclovir prevention may prevent 58% to 71% of severe cCMV cases for 38 € per pregnancy.
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http://dx.doi.org/10.1111/1471-0528.16966 | DOI Listing |
World J Surg Oncol
January 2025
Department of Hepatobiliary and Pancreas, Affiliated Hospital of Qingdao University, NO.1677 Wutaishan Road, Qingdao, Shandong Province, 266555, China.
Background: With the rising diagnostic rate of gallbladder polypoid lesions (GPLs), differentiating benign cholesterol polyps from gallbladder adenomas with a higher preoperative malignancy risk is crucial. This study aimed to establish a preoperative prediction model capable of accurately distinguishing between gallbladder adenomas and cholesterol polyps using machine learning algorithms.
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Am J Trop Med Hyg
January 2025
Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Universidad Autónoma de Yucatán, Mérida, México.
The socioecological conditions of Mexican regions are conducive to the spread of vector-borne diseases. Although there are established treatment guidelines for dengue and rickettsiosis, diagnosis is complicated. The objective of this work was to identify epitopes of Rickettsia and dengue virus that could be used in serology screening against vector-borne diseases.
View Article and Find Full Text PDFJ Med Virol
February 2025
Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil.
Human Immunodeficiency Virus (HIV), Human T Lymphotropic Virus (HTLV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) coinfection may lead to disease progression or worsen its clinical presentation. Viral coinfections screening during blood donation is critical. To identify risk factors for coinfection among blood donors, we assessed the blood donations at the Fundação de Hematologia e Hemoterapia da Bahia, from 2008 to 2017.
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January 2025
Meat Microbiology, ICAR-National Meat Research Institute, Hyderabad, Telangana, India.
is an airborne bacterial zoonotic pathogen that causes Q fever/coxiellosis in humans and animals. Although dogs are suspected of transmitting Q fever to humans in past outbreaks, the prevalence of in the Indian dog population and risk factors for infection remain unknown. In this study, 452 dogs from pet clinics in three Indian states were screened for coxiellosis using molecular (Trans-PCR, Com 1-PCR) and serological (IFAT) tests.
View Article and Find Full Text PDFMed J Armed Forces India
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Professor & Head (Dermatology), DY Patil Medical College & Research Centre, Pune, India.
Background: Autoimmune bullous disorder (AIBD) is a diverse group of blistering dermatoses that affects the skin and mucous membrane, characterized by the formation of autoantibodies against the desmosomal glycoproteins and adhesion molecular components of the basement membrane zone. Various immunoassay techniques for serological diagnosis are Direct Immunofluorescence (DIF), Indirect Immunofluorescence (IIF), Enzyme Linked Immunosorbent Assay (ELISA) and immunoblotting. Quantitative ELISA titer can also be used to monitor the disease activity and response to treatment.
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