Women receive the new test only if it is associated with better outcomes relative to the status quo.
published studies of infection rates among antenatal care attendees and assumed that the same rates apply to women who do not have access to antenatal care. (...) To estimate the prevalence of active syphilis (that is, the cases that require treatment during pregnancy), we relied on
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Table 3 | Incremental congenital syphilis cases averted, stillbirths averted and adjusted lives saved in sub-Saharan Africa with a hypothetical new antenatal syphilis screening diagnostic compared with the status quo
Test Sensitivity (%)
Specificity (%)
Return rate (%)
Treatment rate (%)
Congenital syphilis cases averted (SD)
Stillbirths averted (SD)
Adjusted lives saved (SD)*
Proportion of adjusted lives saved (%)†
Status quo: laboratory-based RPR 86 72 60 70
Advanced/moderate infrastructure‡
1 More sensitive test 95 72 60 70 7,400 (11,100) 6,000 (7,900) 5,900 (7,500) 1
2 More specific test 86 85 60 70 600 (9,000) 500 (6,800) 1,700 (6,600)
3 Perfect test 100 100 60 70 11,200 (12,600) 9,000 (9,800) 11,500 (9,400) 2
4 Perfect treatment 86 72 60 100 28,500 (18,500) 22,900 (13,700) 21,400 (13,300) 5
5 Faster test§ 86 72 100 70 44,000 (22,700) 35,400 (17,700) 33,100 (17,300) 7
6 Faster test and perfect treatment rate
86 72 100 100 90,400 (46,500) 72,700 (31,000) 68,100 (30,600) 15
7 Faster test, perfect test and perfect treatment rate
100 100 100 100 115,600 (51,100) 93,000 (35,800) 94,300 (35,200) 20
Minimal infrastructure‡
8 Laboratory-based RPR test 86 72 60 70 109,800 (48,700) 88,300 (35,100) 82,600 (34,500) 18
9 Less sensitive test 75 72 60 70 95,700 (51,400) 77,000 (34,800) 71,500 (34,400) 15
10 Less specific test 86 65 60 70 109,800 (53,200) 88,300 (41,000) 81,500 (40,500) 18
11 Less sensitive and specific test, faster test and perfect treatment rate
75 65 100 100 297,300 (136,300) 239,100 (92,000) 217,500 (91,000) 47
12 Perfect test 100 100 60 70 138,100 (66,400) 111,100 (46,600) 112,100 (45,800) 24
13 Perfect treatment 86 72 60 100 184,400 (94,100) 148,300 (59,600) 138,800 (58,900) 30
14 Faster test§ 86 72 100 70 225,900 (105,100) 181,700 (76,300) 170,000 (75,300) 37
15 Faster test and perfect treatment rate
86 72 100 100 350,300 (150,200) 281,800 (117,900) 263,700 (116,600) 57
16 Faster test, perfect test and perfect treatment rate
100 100 100 100 417,900 (202,800) 336,100 (144,400) 334,000 (142,500) 72
No infrastructure‡
17 Laboratory-based RPR test 86 72 60 70 167,800 (82,400) 135,000 (55,600) 126,300 (55,200) 27
18 Less sensitive test 75 72 60 70 146,400 (66,900) 117,700 (46,200) 109,300 (45,900) 24
19 Less specific test 86 65 60 70 167,800 (75,600) 135,000 (50,800) 124,600 (50,300) 27
20 Less sensitive and specific test, faster test and perfect treatment rate
75 65 100 100 417,900 (197,600) 336,100 (138,000) 306,100 (136,800) 66
21 Perfect test 100 100 60 70 205,600 (92,700) 165,400 (65,700) 165,700 (64,600) 36
22 Perfect treatment 86 72 60 100 267,400 (122,500) 215,000 (85,600) 201,300 (85,000) 44
23 Faster test§ 86 72 100 70 322,700 (161,600) 259,500 (103,800) 242,900 (102,900) 53
24 Faster test and perfect treatment rate
86 72 100 100 488,600 (218,900) 392,900 (161,200) 367,800 (159,800) 80
25 Faster test, perfect test and perfect treatment rate
100 100 100 100 578,600 (266,500) 465,400 (181,000) 461,500 (178,700) 100
*Adjusted lives saved are the sum of stillbirths averted and lives saved due to a reduction in the harm associated with treatment, and therefore include the impact of treatment harm. (...) For
syphilis, new tests are defined by sensitivity, specificity, infrastructure requirements (advanced/moderate, minimal or no health- care infrastructure), patient return rate (60 or 100%) and RPR-positive treatment rate (70 or 100%).
Language:English
Score: 1167448.2
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https://www.who.int/tdr/public...tions/documents/sti-nature.pdf
Data Source: un