02710nas a2200301 4500000000100000008004100001260001000042653002000052653002300072653002500095653002400120653004100144653003500185653000800220653002900228653001700257653001400274100001500288700002500303700001700328700001400345245019500359856006300554300001200617490000700629520174700636022002502383 2024 d bWiley10aCervical cancer10aCost effectiveness10adecision tree models10aEconomic evaluation10aFemale genital schistosomiasis (FGS)10ahigh-risk human papillomavirus10aHIV10aHome based self-sampling10aMarkov model10aScreening1 aLamberti O1 aTerris‐Prestholt F1 aBustinduy AL1 aBozzani F00aA health decision analytical model to evaluate the cost‐effectiveness of female genital schistosomiasis screening strategies: The female genital schistosomiasis
Female genital schistosomiasis is a chronic gynaecological disease caused by the waterborne parasite Schistosoma (S.) haematobium. It affects an estimated 30–56 million girls and women globally, mostly in sub‐Saharan Africa where it is endemic, and negatively impacts their sexual and reproductive life. Recent studies found evidence of an association between female genital schistosomiasis and increased prevalence of HIV and cervical precancer lesions. Despite the large population at risk, the burden and impact of female genital schistosomiasis are scarcely documented, resulting in neglect and insufficient resource allocation. There is currently no standardised method for individual or population‐based female genital schistosomiasis screening and diagnosis which hinders accurate assessment of disease burden in endemic countries. To optimise financial allocations for female genital schistosomiasis screening, it is necessary to explore the cost‐effectiveness of different strategies by combining cost and impact estimates. Yet, no economic evaluation has explored the value for money of alternative screening methods. This paper describes a novel application of health decision analytical modelling to evaluate the cost‐effectiveness of different female genital schistosomiasis screening strategies across endemic settings. The model combines a decision tree for female genital schistosomiasis screening strategies, and a Markov model for the natural history of cervical cancer to estimate the cost per disability‐adjusted life‐years averted for different screening strategies, stratified by HIV status. It is a starting point for discussion and for supporting priority setting in a data‐sparse environment.
a1360-2276, 1365-3156