COST-EFFECTIVENESS ANALYSIS OF SYPHILIS SCREENING IN SHIRAZ

Abstract: To ascertain the cost-effectiveness of current screening strategies for syphilis, a review of one year period from April 1998 to March 1999, was made at district health office and two women’s hospitals in Shiraz, Iran. In total 20716 patients were screened by means of three different screening programmes (14854 by mandatory premarital screening, 3250 by preemploymet screening and 2612 by antenatal screening programme). Six (0.03%) cases were confirmed, serologically (VDRL, FTA-ABS) to be treponemal infection. To evaluate the cost-effectiveness of such a screening system we developed a decision analysis model. When considering direct medical cost, antenatal screening programme is the most cost-effective. Altogether routine screening programmes for syphilis would be cost-effective even at a lower prevalence (0.022%) and it should be continued because of the fact that the present notification system, due to nonparticipation of a great majority of private physicians, is unreliable. Keywords: Cost-effectiveness, Syphilis, Screening