Congenital toxoplasmosis is a risk for fetus both in'low'and'high risk'areas.
A cost-benefit analysis based on data from a Finnish prospective study (20.3% seropositivity of pregnant mothers and incidence of 2.4/1,000 seronegative pregnancies) and on Finnish cost data was performed to compare the no-screening and screening alternatives for primary toxoplasma infections during pregnancy.
A maternal-feto transmission risk of 40%, effectiveness of treatment of 50%, and discount rate of 4% were used as other baseline probabilities.
The calculations were carried out by decision analysis combined with sensitivity analysis.
The total annual costs of congenital toxoplasmosis without screening amount to US$ 128/pregnancy/year, and with systematic serological screening, US$95/pregnancy.
Thus screening reduces the costs by 25%. The present value of net savings in Finland would be US$ 2.1 million every year.
A one-way sensitivity analysis showed that screening together with health education is preferable to health education without screening if the incidence of maternal primary infections exceeds 1.1/1,000 and effectiveness of treatment is better than 22.1%. Screening for toxoplasma infections during pregnancy is economically worthwhile even in a country with a low incidence.
A scheme of systematic screening for maternal primary toxoplasma infections combined with health education should be considered.
Mots-clés Pascal : Toxoplasmose, Protozoose, Parasitose, Infection, Analyse avantage coût, Education sanitaire, Femelle, Homme, Dépistage, Gestation, Economie santé
Mots-clés Pascal anglais : Toxoplasmosis, Protozoal disease, Parasitosis, Infection, Cost benefit analysis, Health education, Female, Human, Medical screening, Pregnancy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0437121
Code Inist : 002B05E02B5. Création : 01/03/1996.