{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T22:57:16Z","timestamp":1725749836501},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2001,12,25]],"date-time":"2001-12-25T00:00:00Z","timestamp":1009238400000},"content-version":"vor","delay-in-days":480,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2000,9]]},"abstract":"<jats:p><jats:bold>Summary<\/jats:bold>  <jats:sc>objective<\/jats:sc>\u2002\u2002To recommend a cost\u2010effective approach for the management of acute male urethritis in the developing world, based on the findings of a theoretical study.<\/jats:p><jats:p> <jats:sc>methods<\/jats:sc>\u2002\u2002A model was developed to assess the cost\u2010effectiveness of three urethritis management strategies in a theoretical cohort of 1000 men with urethral syndrome. (1) All patients were treated with cefixime and doxycycline for gonococcal urethritis (GU) and nongonococcal urethritis (NGU), respectively, as recommended by WHO. (2) All patients were treated with doxycycline for NGU; treatment with cefixime was based on the result of direct microscopy of a urethral smear. (3) All patients were treated with cotrimoxazole or kanamycin for GU and doxycycline for NGU. Cefixime was kept for patients not responding to the first GU treatment. Strategy costs included consultations, laboratory diagnosis (where applicable) and drugs. The outcome was the rate of patients cured of urethritis. Cost\u2010effectiveness was measured in terms of cost per cured urethritis.<\/jats:p><jats:p> <jats:sc>results<\/jats:sc>\u2002\u2002Strategy costs in our model depended largely on drug costs. The first strategy was confirmed as the most effective but also the most expensive approach. Cefixime should cost no more than US$ 1.5 for the strategy to be the most cost\u2010effective. The second strategy saved money and drugs but proved a valuable alternative only when laboratory performance was optimal. The third strategy with cotrimoxazole was the least expensive but a low follow\u2010up visit rate, poor treatment compliance or lower drug efficacy limited effectiveness. Maximizing compliance by replacing cotrimoxazole with single\u2010dose kanamycin had the single greatest impact on the effectiveness of the third strategy.<\/jats:p><jats:p> <jats:sc>conclusion<\/jats:sc>\u2002\u2002Our model suggested that a cost\u2010effective approach would be to treat gonorrhoea with a single\u2010dose antibiotic selected from locally available products that cost no more than US$\u00a01.5.<\/jats:p>","DOI":"10.1046\/j.1365-3156.2000.00616.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T21:36:02Z","timestamp":1047504962000},"page":"640-647","source":"Crossref","is-referenced-by-count":5,"title":["Cost\u2010effectiveness of management strategies for acute urethritis in the developing world"],"prefix":"10.1111","volume":"5","author":[{"given":"Fran\u00e7ois","family":"Crabb\u00e9","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bea","family":"Vuylsteke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"de Clerck","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Laga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2001,12,25]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/sti.74.3.210"},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1128\/JCM.37.4.1130-1136.1999","article-title":"Antimicrobial susceptibilities and plasmid contents of Neisseria gonorrhoeae isolates from commercial sex workers in Dhaka, Bangladesh: emergence of high\u2010level resistance to ciprofloxacin.","volume":"37","author":"Bhuiyan BU","year":"1999","journal-title":"Journal of Clinical Microbiology"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198204000-00002"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)91380-7"},{"key":"e_1_2_5_6_1","first-page":"833","volume-title":"Sexually Transmitted Diseases","author":"Holmes KK","year":"1999"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/8.4.291"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198104000-00019"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199101000-00008"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/314625"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198907000-00004"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198804000-00002"},{"key":"e_1_2_5_13_1","first-page":"267","article-title":"Prise en charge des maladies sexuellement transmissibles au Cameroun, en milieu urbain, en 1992.","volume":"73","author":"Louis JP","year":"1993","journal-title":"Annales de la Soci\u00e9t\u00e9 Belge de M\u00e9decine Tropicale"},{"key":"e_1_2_5_14_1","volume-title":"International Drug Price Indicator Guide","author":"Management Sciences for Health","year":"1999"},{"key":"e_1_2_5_15_1","first-page":"361","article-title":"The value of urine specimens in screening for male urethritis and its microbial aetiologies in Tanzania.","volume":"68","author":"Mayaud P","year":"1992","journal-title":"Genitourinary Medicine"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/20.Supplement_1.S47"},{"key":"e_1_2_5_17_1","first-page":"323","article-title":"Gonorrhoea treatment failure and ciprofloxacin resistance.","volume":"9","author":"Ng PP","year":"1998","journal-title":"International Journal of Sexually Transmitted Diseases and AIDS"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-199809000-00005"},{"key":"e_1_2_5_19_1","first-page":"331","article-title":"Surveillance of antibiotic susceptibility of Neisseria gonorrhoeae in the WHO western pacific region 1992\u201394.","volume":"73","author":"WHO Western Pacific Region Gonococcal Antimicrobial Surveillance Programme","year":"1997","journal-title":"Genitourinary Medicine"},{"key":"e_1_2_5_20_1","volume-title":"Technical Report Series 810","author":"World Health Organization","year":"1991"},{"key":"e_1_2_5_21_1","volume-title":"Management of Sexually Transmitted Diseases","author":"World Health Organization","year":"1994"}],"container-title":["Tropical Medicine &amp; 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