间日疟原虫感染男性中葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症的快速诊断检测：基于巴西亚马逊地区的预算影响分析

Rapid diagnostic test for G6PD deficiency in Plasmodium vivax-infected men: a budget impact analysis based in Brazilian Amazon.

作者信息

Peixoto Henry Maia, Brito Marcelo Augusto Mota, Romero Gustavo Adolfo Sierra, Monteiro Wuelton Marcelo, de Lacerda Marcus Vinícius Guimarães, de Oliveira Maria Regina Fernandes

机构信息

Centre for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil.

University Centre of Brasília, Brasília, Federal District, Brazil.

出版信息

Trop Med Int Health. 2017 Jan;22(1):21-31. doi: 10.1111/tmi.12800. Epub 2016 Nov 14.

DOI:10.1111/tmi.12800

PMID:27770602

Abstract

OBJECTIVE

The aim of this study was to estimate the incremental budget impact (IBI) of a rapid diagnostic test to detect G6PDd in male patients infected with Plasmodium vivax in the Brazilian Amazon, as compared with the routine protocol recommended in Brazil which does not include G6PDd testing.

METHODS

The budget impact analysis was performed from the perspective of the Brazilian health system, in the Brazilian Amazon for the years 2013, 2014 and 2015. The analysis used a decision model to compare two scenarios: the first consisting of the routine recommended in Brazil which does not include prior diagnosis of dG6PD, and the second based on the use of RDT CareStart™ G6PD (CS-G6PD) in all male subjects diagnosed with vivax malaria. The expected implementation of the diagnostic test was 30% in the first year, 70% the second year and 100% in the third year.

RESULTS

The analysis identified negative IBIs which were progressively smaller in the 3 years evaluated. The sensitivity analysis showed that the uncertainties associated with the analytical model did not significantly affect the results.

CONCLUSION

A strategy based on the use of CS-G6PD would result in better use of public resources in the Brazilian Amazon.

摘要

目的

本研究旨在评估在巴西亚马逊地区，对感染间日疟原虫的男性患者进行葡萄糖-6-磷酸脱氢酶缺乏症（G6PDd）快速诊断检测相较于巴西推荐的不包括G6PDd检测的常规方案所产生的增量预算影响（IBI）。

方法

从巴西卫生系统的角度，对2013年、2014年和2015年巴西亚马逊地区进行预算影响分析。该分析使用决策模型比较两种情况：第一种是巴西推荐的不包括dG6PD预先诊断的常规方案，第二种是对所有诊断为间日疟的男性受试者使用CareStart™ G6PD快速诊断检测（CS-G6PD）。诊断检测的预期实施率在第一年为30%，第二年为70%，第三年为100%。