Selective versus universal antenatal HIV testing : Epidemiological and implementational factors in policy choice.
To develop an epidemiological basis for economic analyses of selective and universal antenatal screening strategies, and to apply it to the UK.
The prevalence of higher-risk women and the prevalence of undiagnosed infection within groups of high-risk and low-risk women was estimated from surveillance and survey data.
The numbers of women tested and the numbers of infected women who would be identified by universal and selective strategies were then calculated under a range of assumptions about the identification of higher-risk women and acceptance of testing.
In higher-risk women estimated prevalence of undiagnosed intection was between 0.06% and 2.8%, comparing well with independent estimates.
In low-risk women, estimates ranged from 0.014% in London to 0.002% in the rest of the UK.
If uptake among the high-risk women was the same in selective and universal strategies, universal testing would entail testing between 7100 (London) and 50 000 (rest of England) additional women to detect an additional case.
However, if selective screening identified only 60% of those at high risk and achieved only 60% acceptance compared with a universal programme, then universal screening would require only 1150 additional women to identify one additional case in London, compared to 6470 in Scotland and 13 140 in the rest of the UK.
Overall prevalence does not form an adequate basis for determining screening strategy. (...)
Mots-clés Pascal : SIDA, Virose, Infection, Dépistage, Prénatal, Analyse coût efficacité, Analyse économique, Méthode, Etude comparative, Epidémiologie, Royaume Uni, Europe, Surveillance sanitaire, Homme, Immunopathologie, Immunodéficit, Prévention
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Medical screening, Prenatal, Cost efficiency analysis, Economic analysis, Method, Comparative study, Epidemiology, United Kingdom, Europe, Sanitary surveillance, Human, Immunopathology, Immune deficiency, Prevention
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0137083
Code Inist : 002B05C02D. Création : 16/11/1999.