Costs and cost-efectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review

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dc.contributor.authorKira Elsbernd
dc.contributor.authorKarl M. F. Emmert‑Fees
dc.contributor.authorAmanda Erbe
dc.contributor.authorVeronica Ottobrino
dc.contributor.authorArne Kroidl
dc.contributor.authorTill Bärnighausen
dc.contributor.authorBenjamin P. Geisler
dc.contributor.authorStefan Kohler
dc.date.accessioned2024-03-28T07:55:16Z
dc.date.available2024-03-28T07:55:16Z
dc.date.issued2022
dc.description.abstractBackground: Continuing progress in the global pediatric human immunodefciency virus (HIV) response depends on timely identifcation and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design and implementation. This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-efectiveness analyses of HIV EID. Methods: We systematically searched bibliographic databases (Embase, MEDLINE and EconLit) and grey literature for economic analyses of HIV EID in low- and middle-income countries published between January 2008 and June 2021. We extracted data on unit costs, cost savings, and incremental cost-efectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats. We converted unit costs to 2021 USD for easier comparison of costs across studies. Results: After title and abstract screening of 1278 records and full-text review of 99 records, we included 29 studies: 17 cost analyses and 12 model-based cost-efectiveness analyses. Unit costs were 21.46–51.80 USD for point-of-care EID tests and 16.21–42.73 USD for laboratory-based EID tests. All cost-efectiveness analyses stated at least one of the interventions evaluated to be cost-efective. Most studies reported costs of EID testing strategies; however, few studies assessed the same intervention or reported costs in the same way, making comparison of costs across studies challenging. Limited data availability of context-appropriate costs and outcomes of children with HIV as well as struc‑ tural heterogeneity of cost-efectiveness modelling studies limits generalizability of economic analyses of HIV EID. Conclusions: The available cost and cost-efectiveness evidence for EID of HIV, while not directly comparable across studies, covers a broad range of interventions and suggests most interventions designed to improve EID are costefective or cost-saving. Further studies capturing costs and benefts of EID services as they are delivered in real-world settings are needed.
dc.description.librarianPM2023
dc.facultyFaculty of Health Sciences
dc.identifier.urihttps://hdl.handle.net/10539/38231
dc.language.isoen
dc.schoolPublic Health
dc.subjectCost efectiveness, Diagnostics, Low- and middle-income countries, Point of care, Early infant diagnosis, Health systems
dc.titleCosts and cost-efectiveness of HIV early infant diagnosis in low- and middle-income countries: a scoping review
dc.typeArticle
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