Table 1 Key characteristics of health economic evaluations related to syphilis infection
Lead author | Evaluation aims | Country | Population targeted by the intervention | Health states included | Source for disability weights or utility weights |
|---|---|---|---|---|---|
Primary outcome: DALYs | |||||
 Bristow (2016) [21] | Assess the health and economic outcomes of a dual testing strategy in a simulated cohort of antenatal care patients in Malawi | Malawi | Women attending antenatal clinic | Congenital syphilis, low birth weight, neonatal death, stillbirth | [76] |
 Hong (2010) [22] | Assess the effectiveness of a program preventing mother-to-child transmission of syphilis | China | Women attending antenatal clinic | Congenital syphilis | |
 Jayawardena (2019) [23] | Analyse alternative options for donor syphilis testing to determine the optimal strategy | Australia | Blood donors | Adult early syphilis, adult tertiary syphilis, congenital syphilis | Durations from [79] |
 Kahn (2014) [24] | Assess the cost-effectiveness of scaling-up syphilis screening and treatment in existing antenatal care programs in various contexts | Modelled scenarios in generic countries | Women attending antenatal clinic | Congenital syphilis, low birth weight, stillbirth, neonatal death | [76] |
 Kuznik (2013) [25] | Evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in sub-Saharan Africa and estimate the impact of universal screening on outcomes | 43 sub-Saharan African countries | Women attending antenatal clinic | Congenital syphilis, stillbirth, neonatal death | [45] |
 Kuznik (2015) [26] | Evaluated the cost-effectiveness of increasing the coverage for antenatal syphilis screening in 11 Asian and 20 Latin American countries using a POC test compared to no testing and no treatment | 11 Asian and 20 Latin American countries | Women attending antenatal clinic | Congenital syphilis, stillbirth, neonatal death | [80] |
 Larson (2014) [27] | Estimate the costs and cost-effectiveness of using rapid syphilis POC tests compared to usual care | Zambia | Women attending antenatal clinic | Congenital syphilis, low birth weight, stillbirth, neonatal death | [24] |
 Owusu-Edusei (2011) [28] | Compare the health and economic outcomes of a dual nontreponemal-treponemal point-of-care test with existing syphilis tests/testing algorithms in a high prevalence setting | Sub-Saharan Africa | Women attending antenatal clinic | Adult early syphilis, adult tertiary syphilis, congenital syphilis, low birth weight, miscarriage, stillbirth, neonatal death | [64] |
 Owusu-Edusei (2014) [29] | Compare the economic and health outcomes of four new antenatal HIV and syphilis screening strategies | China | Women attending antenatal clinic | Adult early syphilis, adult tertiary syphilis, HIV-positive women with syphilis coinfection, congenital syphilis, low birth weight, stillbirth, induced abortion for infected mothers, neonatal death, HIV in newborn | [45] |
 Rodriguez (2021) [30] | Assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence | South Africa, Kenya, Colombia, Ukraine | Women attending antenatal clinic | Congenital syphilis, low birth weight, stillbirth, neonatal death | [10] |
 Romero (2020) [31] | Assess the cost-effectiveness of a rapid point-of-care test and treatment if required compared with a laboratory-based standard test with treatment at the next follow-up visit | Brazil | Women attending antenatal clinic | Congenital syphilis, low birth weight, stillbirth, neonatal death | [54] |
 Russell (2021) [41] | Estimate the cost-effectiveness of testing all blood donations for HIV, hepatitis B and C, and syphilis to avoid adverse health outcomes in recipients | Ghana | Patients receiving blood transfusions | Acute syphilis infection | [42] |
 Schackman (2007) [32] | Estimate the cost-effectiveness, projected health outcomes, and the annual cost of screening pregnant women using a rapid syphilis test | Haiti | Women attending antenatal clinic | Congenital syphilis, stillbirth, neonatal death | [64] |
 Terris-Prestholt (2003) [33] | Estimate the cost-effectiveness of on-site antenatal syphilis screening and treatment | Tanzania | Women attending antenatal clinic | Low birth weight, stillbirth | [44] |
 Terris-Prestholt (2015) [34] | Assess the cost-effectiveness of clinic-based rapid plasma reagin and single rapid syphilis test in 20 antenatal clinics across Peru, Tanzania, and Zambia | Peru, Tanzania, Zambia | Women attending antenatal clinic | Congenital syphilis, low birth weight, stillbirth, neonatal death | Partially from [25] |
Primary outcome: QALYs | |||||
 Castillo (2021) [40] | Develop a modelling framework for cost-effectiveness evaluation of different approaches using rapid tests for the detection of syphilis in inmates’ populations | Chile | Prisoners | Adult syphilis infection (susceptible, stage 1, stage 2, latent, tertiary, immune) | |
 Custer (2010) [42] | Assessed the cost-effectiveness of pathogen reduction technology in mitigating the risk of transfusion-associated infectious and some non-infectious threats | Canada | Patients receiving blood transfusions | Primary syphilis, tertiary syphilis | Assumption for primary syphilis; For tertiary syphilis [57] |
 Eaton (2018) [35] | Compare the cost-effectiveness of the reverse and traditional syphilis screening algorithms in persons living with HIV | United States | People living with HIV | HIV and syphilis infection | [39] |
 Hersh (2018) [36] | Estimate the cost-effectiveness of screening all women during the first and third trimesters compared with screening just once during pregnancy | United States | Women attending antenatal clinic | Congenital syphilis, intrauterine fetal demise, neonatal death, congenital syphilis (maternal perspective), intrauterine fetal demise (maternal perspective), neonatal death (maternal perspective) | For fetal perspectives [58] |
 Huntington (2020) [37] | Assess the cost-effectiveness of universal repeat screening for syphilis in late pregnancy, compared with the current strategy of single screening in early pregnancy with repeat screening offered only to high-risk women | United Kingdom | Women attending antenatal clinic | Congenital syphilis, intrauterine fetal demise, neonatal death | [58] |
 Suijkerbuijk (2018)a [38] | Evaluate intended savings and missed syphilis and/or HIV infections and explore the efficiency of possible test policies | Netherlands | People attending a sexual health clinic | Syphilis | [53] |
 Tuite (2014)a [39] | Evaluate the cost-effectiveness of strategies that increased the frequency and population coverage of syphilis screening in HIV-infected men who have sex with men receiving HIV care relative to the current standard of care | Canada | Men who have sex with men living with HIV | Primary syphilis, secondary syphilis, neurosyphilis and tertiary syphilis | |