van Hulst Marinus, Smit Sibinga Cees Th, Postma Maarten J
Unit of PharmacoEpidemiology and PharmacoEconomics (PE(2)), Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Biologicals. 2010 Jan;38(1):53-8. doi: 10.1016/j.biologicals.2009.10.006. Epub 2009 Dec 21.
Health economics provides a standardised methodology for valid comparisons of interventions in different fields of health care. This review discusses the health economic evaluations of strategies to enhance blood product safety in sub-Saharan Africa.
We reviewed health economic methodology with special reference to cost-effectiveness analysis. We searched the literature for cost-effectiveness in blood product safety in sub-Saharan Africa.
HIV-antibody screening in different settings in sub-Saharan Africa showed health gains and saved costs. Except for adding HIV-p24 screening, adding other tests such as nucleic acid amplification testing (NAT) to HIV-antibody screening displayed incremental cost-effectiveness ratios greater than the WHO/World Bank specified threshold for cost-effectiveness. The addition of HIV-p24 in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may also be cost-effective options for Ghana.
From a health economic viewpoint, HIV-antibody screening should always be implemented in sub-Saharan Africa. The addition of HIV-p24 antigen screening, in combination with HCV antibody/antigen screening and multiplex (HBV, HCV and HIV) NAT in pools of 24 may be feasible options for Ghana. Suggestions for future health economic evaluations of blood transfusion safety interventions in sub-Saharan Africa are: mis-transfusion, laboratory quality and donor management.
卫生经济学提供了一种标准化方法，用于对不同医疗领域的干预措施进行有效比较。本综述讨论了撒哈拉以南非洲地区提高血液制品安全性策略的卫生经济评估。
我们回顾了卫生经济方法，特别提及成本效益分析。我们在文献中搜索撒哈拉以南非洲地区血液制品安全性方面的成本效益情况。
撒哈拉以南非洲不同地区的HIV抗体筛查显示出健康收益并节省了成本。除了增加HIV-p24筛查外，在HIV抗体筛查中增加其他检测，如核酸扩增检测（NAT），其增量成本效益比高于世界卫生组织/世界银行规定的成本效益阈值。对于加纳来说，将HIV-p24与HCV抗体/抗原筛查以及24人份混合的多重（HBV、HCV和HIV）NAT联合使用也可能是具有成本效益的选择。
从卫生经济学角度来看，撒哈拉以南非洲地区应始终实施HIV抗体筛查。对于加纳来说，增加HIV-p24抗原筛查，与HCV抗体/抗原筛查以及24人份混合的多重（HBV、HCV和HIV）NAT联合使用可能是可行的选择。对撒哈拉以南非洲地区输血安全干预措施未来卫生经济评估的建议包括：误输血、实验室质量和献血者管理。
