Banca de QUALIFICAÇÃO: Raíssa Allan Santos Domingues

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : Raíssa Allan Santos Domingues
DATE: 15/12/2023
TIME: 14:30
LOCAL: Núcleo de Medicina Tropical - Auditório Aluizio Prata
TITLE:

IS THE DETECTION OF HISTOPLASMA CAPSULATUM ANTIGEN AN EFFICIENT TOOL IN THE DIAGNOSIS OF HISTOPLASMOSIS IN PEOPLE LIVING WITH HIV/AIDS?

KEY WORDS:

Histoplasmosis; HIV-Aids; Economics; Efficiency 

PAGES: 90
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Clínica Médica
SPECIALTY: Doenças Infecciosas e Parasitárias
SUMMARY:

Introduction: Histoplasmosis is a systemic mycosis caused by dimorphic fungi of the species Histoplasma capsulatum. Disseminated histoplasmosis is one of the main infections that support the AIDS definition and one of the main death causes of individuals with HIV in Brazil and in the Americas. Methods: This study aims to develop three economic studies: cost-of-illness analysis, cost-effectiveness analysis and budget impact analysis. The cost-of-illness study was realized at the Brazilian public health system and societal perspective. A hypothetical cohort was conducted based on epidemiological data of HIV and histoplasmosis reported cases in Brazil in 2021. The direct medical costs regarding diagnosis, treatment and care provide to patients with histoplasmosis and the indirect costs related to productivity loss due to premature mortality and morbidity were estimated. The cost-effectiveness analysis will be developed at the Brazilian public health system and societal perspective using a lifetime analytical horizon, with the following outcomes: correctly diagnosed cases, reduction in hospitalizations, as complications and deaths avoided. The diagnosis implementation scenario using the histoplasmosis antigen detection will be comparted to the currently available diagnostics tests (cell culture and radial immunodiffusion) at the Brazilian public health system. Deterministic and probabilistic univariate sensitivity analysis will be performed. The budget impact analysis is going to be performed comparing the reference scenario reflecting the current SUS recommendation for the histoplasmosis diagnosis and treatment with the alternative scenario evaluating the antigen detection test for all histoplasmosis suspected cases, over a three-year time horizon, generating annual estimates based on the events sequence and their probabilities. Results: The total cost of histoplasmosis in Brazil in 2021 were R$ 12,994,607.99, most of it were related to the diagnostics procedures (39.63%), followed by indirect costs related to productivity loss due to premature mortality and morbidity (31.20%), hospitalizations costs (19.97%) and finally outpatient treatment (9.19%). Conclusion: Improving access to the histoplasmosis diagnosis may provide more efficient and timely therapy for patients susceptible to this fungal infection. The proposed analysis could support the decision-making process to expand diagnostic access to histoplasmosis suspected cases, consequently improving care for people living with HIV/AIDS in Brazil.

COMMITTEE MEMBERS:
Interno - 2279074 - GUSTAVO ADOLFO SIERRA ROMERO
Interna - 235612 - MARIA REGINA FERNANDES DE OLIVEIRA
Externo ao Programa - 1041337 - IVAN RICARDO ZIMMERMANN - UnBExterna à Instituição - FLÁVIA TAVARES SILVA ELIAS - FIOCRUZ