UNASSIGNED: we estimated costs for screening, diagnostics, and treatment. We conducted a cross-sectional study in seven regions with primary data collected from 50 health facilities. Data collection included structured questionnaires, with secondary data from the Ministry of Health and other sources. A mixed-methods approach combined ingredients-based costing and financial expenditures to estimate direct medical and non-medical costs. All costs are reported in 2019 USD.
UNASSIGNED: average costs were $3.71 for visual inspection with acetic acid, $16.49 for Pap smear, and $46.65 for human papillomavirus deoxyribonucleic acid (HPV DNA) testing. Screening cost drivers were clinical exam supplies and clinical equipment for visual inspection with acetic acid, offsite processing of specimens for Pap smear, and lab equipment costs for HPV DNA procedure. The average cost of diagnosis via colposcopy alone was $25.73, and colposcopy with biopsy/endocervical curettage was $74.96. The average cost of treatment followed by one visit for pre-cancerous lesions was $195.24 for loop electrosurgical excision, $47.35 for cryotherapy, and $32.35 for thermal ablation. Clinical equipment and lab costs were the largest contributors to colposcopy and endocervical curettage/biopsy expenses. Clinical equipment made up the largest portion of cryotherapy, loop electrosurgical excision, and thermoablation costs.
UNASSIGNED: this study is the first to estimate the costs of HPV screening and treatment in Senegal, which can be used to inform decision-making on cervical cancer investments.
■我们估计了筛查的费用,诊断,和治疗。我们在七个地区进行了一项横断面研究,从50个医疗机构收集了主要数据。数据收集包括结构化问卷,来自卫生部和其他来源的二级数据。混合方法方法将基于成分的成本计算和财务支出相结合,以估算直接医疗和非医疗成本。所有费用均以2019美元报告。
■用乙酸进行目视检查的平均成本为3.71美元,子宫颈抹片检查16.49美元,和46.65美元的人乳头瘤病毒脱氧核糖核酸(HPVDNA)检测。筛查成本驱动因素是临床检查用品和用乙酸目视检查的临床设备,巴氏涂片标本的异地处理,和HPVDNA程序的实验室设备成本。仅通过阴道镜诊断的平均费用为$25.73,而阴道镜活检/宫颈内刮治的平均费用为$74.96。1次随访癌前病变的平均治疗费用为195.24美元,用于环形电切术。冷冻疗法47.35美元,热消融费用为32.35美元。临床设备和实验室费用是阴道镜检查和宫颈刮治/活检费用的最大贡献者。临床设备构成了冷冻治疗的最大部分,环形电切术,和热消融成本。
■这项研究是第一个估计塞内加尔HPV筛查和治疗费用的研究,可用于为宫颈癌投资决策提供信息。