15 January 2019

Universal screening of individual blood donations for Zika virus has proved to be not cost-effective, according to a US study.

Researchers studied the impact of screening across all 50 USA states and Puerto Rico. Universal screening began in 2016, following the 2015 Zika epidemic in the Americas, which was the largest outbreak to date.

However, a microsimulation study by researchers at Stanford University, Vitalant Research Institute, and the American Red Cross, has found that widespread screening would only be cost-effective in the high mosquito season in Puerto Rico, and never in the 50 states.

Microsimulation was used to estimate the effectiveness and cost-effectiveness of universal individual donation nucleic acid testing (ID-NAT), universal mini-pool NAT, and alternative Zika virus screening policies in Puerto Rico and the 50 states.

It captured Zika-related harms to transfusion recipients, sexual partners and their infants to weigh the cost/benefit of universal screening.

The researchers discovered that during the first year of testing, screening was cost-effective only in the high mosquito season in Puerto Rico - and no evaluated screening policy was cost-effective in the 50 states.

The authors, writing in the journal Annals of Internal Medicine, say their findings suggest that it would be beneficial to reconsider the universal blood screening policy.

Source: Russell, W.A., Stramer, S.L., Busch, M.P., Custer, B. (2019) “Screening the Blood Supply for Zika Virus in the 50 U.S. States and Puerto Rico: A Cost-Effectiveness Analysis”, Annals of Internal Medicine, available at doi: 10.7326/M18-2238


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