{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:42:53Z","timestamp":1790048573766,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,26]],"date-time":"2019-05-26T00:00:00Z","timestamp":1558828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vox Sanguinis"],"published-print":{"date-parts":[[2019,7]]},"abstract":"\n Background and Objectives<\/jats:title>\n \n Currently,\n HTLV<\/jats:styled-content>\n screening is not performed in South Africa (\n SA<\/jats:styled-content>\n ). This report describes an economic assessment (budget impact and cost\u2010effectiveness) of implementing different\n HTLV<\/jats:styled-content>\n screening strategies.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A modified version of the Alliance of Blood Operators risk\u2010based decision\u2010making framework was used to assess the risk and consequences of\n HTLV<\/jats:styled-content>\n in the blood supply in\n SA<\/jats:styled-content>\n . We developed a deterministic model of the cost and consequences of four screening strategies: none, universal, all donors once and first time donors only assuming a transfusion\u2010transmission (\n TT<\/jats:styled-content>\n ) efficiency of 10% and a manifestation of clinical disease of 6%.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Unscreened blood results in 3\u00b755 symptomatic\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n cases and a total healthcare cost of Rand (R)3\u00a0446\u00a0950 (\n US<\/jats:styled-content>\n Dollars (\n USD<\/jats:styled-content>\n )229\u00a0800) annually. Universal screening would cost R24\u00a0000\u00a0000 (\n USD<\/jats:styled-content>\n 1\u00a0600\u00a0000) per annum and prevent 3\u00b754 (99\u00b78%) symptomatic\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n cases in the first year and 0\u00b755 (98\u00b74%) symptomatic\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n cases in the second year at a cost per\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n prevented of R6\u00a0780\u00a0000 (\n USD<\/jats:styled-content>\n 450\u00a0000) in year one and R43\u00a0254\u00a0000 (\n USD<\/jats:styled-content>\n 2\u00a0890\u00a0000) in year two. Screening all donors once would cost R16,200,000 (\n USD<\/jats:styled-content>\n 1\u00a0080\u00a0000) or R4\u00a0600\u00a0000 (\n USD<\/jats:styled-content>\n 306\u00a0000) per symptomatic\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n infection prevented in year one. Total costs decrease to R5\u00a0100\u00a0000 (\n USD<\/jats:styled-content>\n 340\u00a0000) in year 2 but the cost per\n TT<\/jats:styled-content>\n \u2010\n HTLV<\/jats:styled-content>\n prevented increases to R10\u00a0700\u00a0000 (\n USD<\/jats:styled-content>\n 713\u00a0333).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This analysis contributed to the decision not to implement\n HTLV<\/jats:styled-content>\n screening as the healthcare budget and particularly the budget for blood transfusion in\n SA<\/jats:styled-content>\n is insufficient to provide appropriate treatment. Arguably, available resources can be more efficiently utilized in other healthcare programs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/vox.12788","type":"journal-article","created":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T01:18:23Z","timestamp":1558919903000},"page":"467-477","source":"Crossref","is-referenced-by-count":8,"title":["Health economic implications of testing blood donors in South Africa for\n HTLV<\/scp>\n 1 & 2 infection"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4383-4526","authenticated-orcid":false,"given":"Marion","family":"Vermeulen","sequence":"first","affiliation":[{"name":"South African National Blood Service Weltevreden Park South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"van den Berg","sequence":"additional","affiliation":[{"name":"South African National Blood Service Weltevreden Park South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Sykes","sequence":"additional","affiliation":[{"name":"South African National Blood Service Weltevreden Park South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Reddy","sequence":"additional","affiliation":[{"name":"South African National Blood Service Weltevreden Park South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Ingram","sequence":"additional","affiliation":[{"name":"South African Bone Marrow Registry Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colwyn","family":"Poole","sequence":"additional","affiliation":[{"name":"South African National Blood Service Weltevreden Park South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Custer","sequence":"additional","affiliation":[{"name":"Vitalant Research Institute San Francisco CA USA"},{"name":"Department of Laboratory Medicine University of California San Francisco San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2012.00388"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.onc.1208968"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/17441692.2013.790461"},{"key":"e_1_2_7_5_1","unstructured":"Anon\u2010WHO:Screening of donated blood for transfusion transmissible infections; Recommendations to blood transfusion services. 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