Título:	Real-life quantitative G6PD screening in Plasmodium vivax patients in the Brazilian Amazon : a cost-effectiveness analysis
Autor(es):	Sousa, José Diego Brito Peixoto, Henry Maia Devine, Angela Silva Neto, Alexandre V. Balieiro, Patricia C. S. Sampaio, Vanderson S. Silva, Sheila Vitor Mendes, Maxwell O. Souza, Brenda K. A. Lacerda, Marcus V. G. Monteiro, Wuelton M.
ORCID:	https://orcid.org/0000-0002-0848-1940
Afiliação do autor:	Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde Universidade de Brasilia, Faculdade de Medicina Charles Darwin University, Global and Tropical Health Division, Menzies School of Health Research University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde Fundação de Vigilância em Saúde Dr Rosemary Costa Pinto–FVS-RCP Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade Federal do Amazonas–UFAM, Escola de Enfermagem de Manaus Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Instituto Leônidas & Maria Deane–ILMD, Fundação Oswaldo Cruz Instituto de Pesquisa Clínica Carlos Borborema, Fundação de Medicina Tropical Dr Heitor Vieira Dourado Universidade do Estado do Amazonas, Escola Superior de Ciências da Saúde
Assunto:	Plasmodium vivax Deficiência de glicose-6-fosfato desidrogenase
Data de publicação:	24-Mar-2022
Editora:	Plos
Referência:	PLOS Neglected Tropical Diseases, mar. 2022. DOI: https://doi.org/10.1371/journal.pntd.0010325. Disponível em: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010325.
Abstract:	Background As quantitative glucose 6-phosphate dehydrogenase deficiency (G6PDd) screening tools are evaluated in operational studies, questions remain as to whether they are cost-effective. Here, a cost-effectiveness analysis (CEA) was performed to estimate the Incremental Cost-effectiveness Ratio (ICER) of the introduction of quantitative screening test to detect G6PDd among P. vivax carriers in two municipalities in the Brazilian Amazon. Methodology/Principal findings This cost-effectiveness analysis evaluated the use of the Standard G6PD quantitative screening test in vivax malaria treatment units in two municipalities of the Brazilian Amazon. Using the perspective of the Brazilian public health system, the analysis was performed for the outcome ‘PQ-associated hospitalization avoided’, based on a decision tree model. The results indicated that the G6PDd screening strategy compared with the routine strategy was highly cost-effective, with an ICER of US$495 per additional hospitalization avoided, which represented less than 8% of one Brazilian gross domestic product per capita (US$6,822). The uncertainties evaluated in the sensitivity analysis did not significantly affect the ICER identified in the base-case. Conclusions/Significance This cost-effectiveness analysis showed the quantitative G6PD testing was effective in avoiding PQ-associated hospitalizations. The incorporation of G6PD screening is of paramount importance towards P. vivax malaria elimination in the Amazon to promote the safe use of primaquine and tafenoquine.
Unidade Acadêmica:	Faculdade de Medicina (FMD)
Licença:	Copyright: © 2022 Brito-Sousa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI:	https://doi.org/10.1371/journal.pntd.0010325
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