{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:15:01Z","timestamp":1783448101447,"version":"3.55.0"},"reference-count":33,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["225468\/Z\/22\/Z"],"award-info":[{"award-number":["225468\/Z\/22\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,6,22]]},"abstract":"\n Background<\/jats:title>\n \n Sexually transmitted infections (STIs) including\n Chlamydia trachomatis<\/jats:italic>\n ,\n Neisseria gonorrhoeae<\/jats:italic>\n and\n Trichomonas vaginalis<\/jats:italic>\n during pregnancy are associated with adverse birth outcomes. However, there are limited published data available on cost estimates for implementing such screening. The aim of this study was to estimate the cost of integrating point-of-care STI screening into antenatal care in Harare, Zimbabwe, compared with a modelled standard of care (syndromic management).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We implemented screening for\n C. trachomatis<\/jats:italic>\n ,\n N. gonorrhoeae<\/jats:italic>\n and\n T. vaginalis<\/jats:italic>\n in antenatal care at two primary healthcare clinics in Harare, Zimbabwe, between 12 January 2023 and 23 October 2023. Economic costs required to deliver the testing strategy from a health system perspective were collected using a bespoke cost extraction tool based on study records, staff interviews, time-and-motion studies, local authority salary scales and other secondary sources. During the study, implementation within high-volume settings was found to not be operationally feasible, so implementation within a low-volume setting in routine care, without time required for research processes, was modelled for a 12-month period. The incremental cost per person screened and treated was calculated comparing point-of-care testing to a modelled standard of care using syndromic management.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The composite prevalence of\n C. trachomatis<\/jats:italic>\n ,\n N. gonorrhoeae<\/jats:italic>\n and\/or\n T. vaginalis<\/jats:italic>\n as measured in the intervention was 28.3% (283\/1000). As a proportion of the total cost of the intervention, the largest components were test kits (55.4%), personnel (31.0%), and equipment costs (7.5%). The costs per person screened and treated were $41 and $146, respectively. The incremental costs per person screened and treated compared with syndromic management were $41 and $169, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The incremental cost per person screened and treated for an STI using a point-of-care antenatal screening strategy was driven by test kit and personnel costs, underlining the need for lower cost point-of-care STI diagnostics.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n NCT05541081<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056899","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:25:30Z","timestamp":1783445130000},"page":"sextrans-2025-056899","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Point-of-care screening for curable sexually transmitted infections in antenatal care in Zimbabwe: a costing study"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct05541081","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6561-1353","authenticated-orcid":false,"given":"Kevin","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"},{"name":"Department of Global Health and Infection, Brighton and Sussex Medical School, University of Brighton and University of Sussex, Brighton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bath","sequence":"additional","affiliation":[{"name":"Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rangarirayi","family":"Nyamwanza","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethel","family":"Dauya","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsitsi","family":"Bandason","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chido","family":"Dziva Chikwari","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"},{"name":"MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Simms","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"},{"name":"MRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Institute of Global Health and Infectious Diseases, UNC Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Machiha","sequence":"additional","affiliation":[{"name":"AIDS and TB Unit, Ministry of Health and Child Care, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7585-4743","authenticated-orcid":false,"given":"Michael","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Hospital for Tropical Diseases, University College London Hospitals NHS Foundation Trust, London, UK"},{"name":"Division of Infection and Immunity, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Kranzer","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"},{"name":"Institute of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich, Munich, Germany"},{"name":"German Center for Infection Research (DZIF), partner site Munich, Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashida A.","family":"Ferrand","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"2026070710252107000_sextrans-2025-056899v1.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.228486"},{"key":"2026070710252107000_sextrans-2025-056899v1.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.eclinm.2023.102125","article-title":"Evaluation of a community-based aetiological approach for sexually transmitted infections management for youth in Zimbabwe: intervention findings from the STICH cluster randomised trial","volume":"62","author":"Chikwari","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026070710252107000_sextrans-2025-056899v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054653"},{"key":"2026070710252107000_sextrans-2025-056899v1.4","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16774"},{"key":"2026070710252107000_sextrans-2025-056899v1.5","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-053999"},{"key":"2026070710252107000_sextrans-2025-056899v1.6","unstructured":"World Health Organization . Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. 2022."},{"key":"2026070710252107000_sextrans-2025-056899v1.7","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/S2352-4642(20)30335-7","article-title":"Uptake of and factors associated with testing for sexually transmitted infections in community-based settings among youth in Zimbabwe: a mixed-methods study","volume":"5","author":"Martin","year":"2021","journal-title":"Lancet Child Adolesc Health"},{"key":"2026070710252107000_sextrans-2025-056899v1.8","doi-asserted-by":"crossref","DOI":"10.1155\/2018\/3946862","article-title":"Acceptability and Feasibility of Integrating Point-of-Care Diagnostic Testing of Sexually Transmitted Infections into a South African Antenatal Care Program for HIV-Infected Pregnant Women","volume":"2018","author":"Morikawa","year":"2018","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2026070710252107000_sextrans-2025-056899v1.9","unstructured":"Wynn A , Ramogola-Masire D , Gaolebale P , et al . Acceptability and Feasibility of Sexually Transmitted Infection Testing and Treatment among Pregnant Women in Gaborone. Biomed Res Int 2015;1251238."},{"key":"2026070710252107000_sextrans-2025-056899v1.10","doi-asserted-by":"crossref","first-page":"e1544","DOI":"10.1016\/S2214-109X(24)00266-3","article-title":"WHO global research priorities for sexually transmitted infections","volume":"12","author":"Gottlieb","year":"2024","journal-title":"Lancet Glob Health"},{"key":"2026070710252107000_sextrans-2025-056899v1.11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0253135","article-title":"Economic evaluation of point-of-care testing and treatment for sexually transmitted and genital infections in pregnancy in low- and middle-income countries: A systematic review","volume":"16","author":"Saweri","year":"2021","journal-title":"PLoS One"},{"key":"2026070710252107000_sextrans-2025-056899v1.12","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2007.026930"},{"key":"2026070710252107000_sextrans-2025-056899v1.13","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/OLQ.0000000000001517","article-title":"Bridging the Gap Between Pilot and Scale-Up: A Model of Antenatal Testing for Curable Sexually Transmitted Infections From Botswana","volume":"49","author":"Wynn","year":"2022","journal-title":"Sex Transm Dis"},{"key":"2026070710252107000_sextrans-2025-056899v1.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-070889","article-title":"Investigating point-of-care diagnostics for sexually transmitted infections and antimicrobial resistance in antenatal care in Zimbabwe (IPSAZ): protocol for a mixed-methods study","volume":"13","author":"Martin","year":"2023","journal-title":"BMJ Open"},{"key":"2026070710252107000_sextrans-2025-056899v1.15","unstructured":"Zimbabwe Ministry of Health and Child Care . National STI management guidelines. 2019."},{"key":"2026070710252107000_sextrans-2025-056899v1.16","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/bmjgh-2025-019820","article-title":"Integrating point-of-care screening for curable sexually transmitted infections with HIV, syphilis and hepatitis B screening in antenatal care services in Zimbabwe: a mixed-methods process evaluation","volume":"10","author":"Martin","year":"2025","journal-title":"BMJ Glob Health"},{"key":"2026070710252107000_sextrans-2025-056899v1.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.04.015"},{"key":"2026070710252107000_sextrans-2025-056899v1.18","unstructured":"Harare City Health Department . Report on the city health department. 2022."},{"key":"2026070710252107000_sextrans-2025-056899v1.19","doi-asserted-by":"crossref","unstructured":"Xie T-A , Liu Y-L , Meng R-C , et al . Evaluation of the Diagnostic Efficacy of Xpert CT\/NG for Chlamydia trachomatis and Neisseria gonorrhoeae. Biomed Res Int 2020.","DOI":"10.1155\/2020\/2892734"},{"key":"2026070710252107000_sextrans-2025-056899v1.20","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-026888","article-title":"Diagnostic accuracy of the Xpert CT\/NG and OSOM Trichomonas Rapid assays for point-of-care STI testing among young women in South Africa: a cross-sectional study","volume":"9","author":"Garrett","year":"2019","journal-title":"BMJ Open"},{"key":"2026070710252107000_sextrans-2025-056899v1.21","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.2.684-687.2005"},{"key":"2026070710252107000_sextrans-2025-056899v1.22","doi-asserted-by":"publisher","DOI":"10.1086\/518851"},{"key":"2026070710252107000_sextrans-2025-056899v1.23","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2009.042168"},{"key":"2026070710252107000_sextrans-2025-056899v1.24","doi-asserted-by":"publisher","DOI":"10.1177\/0956462414534833"},{"key":"2026070710252107000_sextrans-2025-056899v1.25","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2016-053063"},{"key":"2026070710252107000_sextrans-2025-056899v1.26","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10068-8"},{"key":"2026070710252107000_sextrans-2025-056899v1.27","unstructured":"DxConnext . Cepheid accessible pricing. n.d. Available: https:\/\/dxc-marketplace.finddx.org\/pages\/cepheid-accessible-pricing"},{"key":"2026070710252107000_sextrans-2025-056899v1.28","doi-asserted-by":"crossref","first-page":"e641","DOI":"10.1016\/S2214-109X(24)00004-4","article-title":"Point-of-care testing and treatment of sexually transmitted and genital infections to improve birth outcomes in high-burden, low-resource settings (WANTAIM): a pragmatic cluster randomised crossover trial in Papua New Guinea","volume":"12","author":"Riddell","year":"2024","journal-title":"Lancet Glob Health"},{"key":"2026070710252107000_sextrans-2025-056899v1.29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41564-018-0295-3","article-title":"REASSURED diagnostics to inform disease control strategies, strengthen health systems and improve patient outcomes","volume":"4","author":"Land","year":"2019","journal-title":"Nat Microbiol"},{"key":"2026070710252107000_sextrans-2025-056899v1.30","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1177\/0956462416689755","article-title":"Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis screening and treatment of pregnant women in Port-au-Prince, Haiti","volume":"28","author":"Bristow","year":"2017","journal-title":"Int J STD AIDS"},{"key":"2026070710252107000_sextrans-2025-056899v1.31","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-016-1573-4","article-title":"A novel point-of-care testing strategy for sexually transmitted infections among pregnant women in high-burden settings: results of a feasibility study in Papua New Guinea","volume":"16","author":"Badman","year":"2016","journal-title":"BMC Infect Dis"},{"key":"2026070710252107000_sextrans-2025-056899v1.32","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17041252","article-title":"A Narrative Review of the Role of Economic Crisis on Health and Healthcare Infrastructure in Three Disparate National Environments","volume":"17","author":"Claborn","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2026070710252107000_sextrans-2025-056899v1.33","unstructured":"Kevin M , Ethel D , Rangarirayi N , et al . Integrating point-of-care screening for curable sexually transmitted infections with HIV, syphilis and hepatitis B screening in antenatal care services in Zimbabwe: a mixed-methods process evaluation. BMJ Glob Health 2025. doi:10.17037\/DATA.00004775"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056899","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:25:49Z","timestamp":1783445149000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056899"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":33,"alternative-id":["10.1136\/sextrans-2025-056899"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056899","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]}}}