Cost-Effectiveness of Improved Treatment Services for Sexually Transmitted Diseases in Preventing HIV-1 Infection in Mwanza Region, Tanzania

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Cost-Effectiveness of Improved Treatment Services for Sexually Transmitted Diseases in Preventing HIV-1 Infection in Mwanza Region, Tanzania

Lancet (12/20/97-12/27/97) Vol. 350, No. 9094, P. 1805
Gilson, Lucy; Mkanje, Rashid; Grosskurth, Heiner; et al.

Abstract: To determine the effect of improved management practices in sexually transmitted disease programs located in Mwanza, Tanzania, on HIV infection rates, researchers from the London School of Hygiene and Tropical Medicine and elsewhere compared six intervention communities with six matched communities. The researchers also estimated the total and incremental costs of the intervention to calculate the total cost per case treated, the incremental cost per HIV infection averted, and the incremental cost per disability-adjusted life-year (DALY) saved. During two years of follow up--during which 11,632 cases of STDs were treated--the incidence of HIV-1 infection was 1.16 percent in the intervention communities and 1.86 percent in the comparison communities. This was down from the 4 percent baseline prevalence of HIV-1 infection. Based upon these findings, the researchers estimate that 252 HIV infections were averted each year. The incremental annual cost of the intervention, meanwhile, totaled $54,839--equal to $217.62 per HIV infection averted and $10.33 per DALY saved based on Tanzanian life expectancy. This cost-effectiveness, the researchers report, compares favorably with other successful intervention programs, such as childhood immunization efforts. However, cost effectiveness could be improved even further if the intervention is expanded on a larger scale.

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