Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado, Manaus, Brazil.
Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.
PLoS Negl Trop Dis. 2022 Mar 24;16(3):e0010325. doi: 10.1371/journal.pntd.0010325. eCollection 2022 Mar.
As quantitative glucose 6-phosphate dehydrogenase deficiency (G6PDd) screening tools are evaluated in operational studies, questions remain as to whether they are cost-effective. Here, a cost-effectiveness analysis (CEA) was performed to estimate the Incremental Cost-effectiveness Ratio (ICER) of the introduction of quantitative screening test to detect G6PDd among P. vivax carriers in two municipalities in the Brazilian Amazon.
METHODOLOGY/PRINCIPAL FINDINGS: This cost-effectiveness analysis evaluated the use of the Standard G6PD quantitative screening test in vivax malaria treatment units in two municipalities of the Brazilian Amazon. Using the perspective of the Brazilian public health system, the analysis was performed for the outcome 'PQ-associated hospitalization avoided', based on a decision tree model. The results indicated that the G6PDd screening strategy compared with the routine strategy was highly cost-effective, with an ICER of US$495 per additional hospitalization avoided, which represented less than 8% of one Brazilian gross domestic product per capita (US$6,822). The uncertainties evaluated in the sensitivity analysis did not significantly affect the ICER identified in the base-case.
CONCLUSIONS/SIGNIFICANCE: This cost-effectiveness analysis showed the quantitative G6PD testing was effective in avoiding PQ-associated hospitalizations. The incorporation of G6PD screening is of paramount importance towards P. vivax malaria elimination in the Amazon to promote the safe use of primaquine and tafenoquine.
随着定量葡萄糖-6-磷酸脱氢酶缺乏症（G6PDd）筛查工具在实际研究中的评估，人们仍然存在疑问，即它们是否具有成本效益。在此，我们进行了一项成本效益分析（CEA），以估计在巴西亚马逊地区的两个城市中引入定量筛查试验来检测间日疟原虫携带者的 G6PDd 的增量成本效益比（ICER）。
方法/主要发现：这项成本效益分析评估了在巴西亚马逊地区的两个城市的间日疟治疗单位中使用标准 G6PD 定量筛查试验的效果。从巴西公共卫生系统的角度出发，基于决策树模型，针对“避免因 PQ 相关的住院治疗”这一结果进行了分析。结果表明，与常规策略相比，G6PDd 筛查策略具有很高的成本效益，每避免一次因 PQ 相关的住院治疗的增量成本效益比为 495 美元，这代表着每人均国内生产总值（GDP）不到 8%（6822 美元）。敏感性分析中评估的不确定性并未显著影响基础病例中确定的 ICER。
结论/意义：这项成本效益分析表明，定量 G6PD 检测可有效避免因 PQ 相关的住院治疗。在亚马逊地区消除间日疟原虫感染时，纳入 G6PD 筛查对于促进使用伯氨喹和他非诺喹的安全性至关重要。
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