McClamroch Kristi, Behets Frieda, Van Damme Kathleen, Rabenja Lovaniaina Ny, Myers Evan
Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, SUNY, Rensselaer, New York, USA.
Sex Transm Dis. 2007 Sep;34(9):631-7. doi: 10.1097/01.olq.0000258107.75888.0e.
According to the national guidelines developed in 2001, a woman at high risk of gonorrhea and chlamydia in Madagascar is treated presumptively at her first sexually transmitted infection clinic visit; risk-based treatment (RB) is subsequently used at 3-month visits.
To compare health and economic outcomes for a 2-stage Markov process with the following 3 cervical infection treatment policies at baseline and at 3-month follow-up visit: presumptive treatment (PT), RB, and an interim laboratory/risk-based policy.
Cost-effectiveness analysis was used to compare the 9 treatment strategies.
When 3-month incidence of cervical infection is <20%, the national guidelines are less costly and less effective than both RB followed by PT, and PT at both visits.
The national guidelines are a reasonable strategy, especially in the context of resource constraints, relatively low reinfection rates, and local preferences.
根据2001年制定的国家指南，马达加斯加淋病和衣原体感染高危女性在首次就诊于性传播感染诊所时接受推定治疗；随后在3个月复诊时采用基于风险的治疗（RB）。
比较在基线和3个月随访时，两阶段马尔可夫过程与以下三种宫颈感染治疗策略的健康和经济结果：推定治疗（PT）、RB以及一种临时实验室/基于风险的策略。
采用成本效益分析来比较这9种治疗策略。
当宫颈感染的3个月发病率<20%时，国家指南在成本和效果方面均低于先采用RB后采用PT以及两次就诊均采用PT的策略。
国家指南是一种合理的策略，尤其是在资源有限、再感染率相对较低以及当地有相应偏好的情况下。
