Advanced

A cost-effectiveness analysis of screening and treatment for Chlamydia trachomatis infection in asymptomatic women

Genc, Mehmet and Mårdh, Per-Anders LU (1996) In Annals of Internal Medicine 124(1 Pt 1). p.1-7
Abstract
OBJECTIVE: To assess the cost-effectiveness of identifying and treating asymptomatic female carriers of Chlamydia trachomatis. DESIGN: Cost-effectiveness analysis based on previously reported cohort analytic studies and average salaries and costs of medical care in Sweden. SETTING: Women attending youth, family planning, and gynecology clinics. PARTICIPANTS: 1000 women and their male sex partners. INTERVENTION: Screening with tissue cell culture, confirmed enzyme immunoassay, and DNA amplification assays based on either polymerase chain reaction or ligase chain reaction was compared with no screening (no treatment and no tracing of sexual contacts). The effect of antibiotic regimens on the outcome of the screening strategies was also... (More)
OBJECTIVE: To assess the cost-effectiveness of identifying and treating asymptomatic female carriers of Chlamydia trachomatis. DESIGN: Cost-effectiveness analysis based on previously reported cohort analytic studies and average salaries and costs of medical care in Sweden. SETTING: Women attending youth, family planning, and gynecology clinics. PARTICIPANTS: 1000 women and their male sex partners. INTERVENTION: Screening with tissue cell culture, confirmed enzyme immunoassay, and DNA amplification assays based on either polymerase chain reaction or ligase chain reaction was compared with no screening (no treatment and no tracing of sexual contacts). The effect of antibiotic regimens on the outcome of the screening strategies was also evaluated. RESULTS: When the prevalence of chlamydial infection exceeded 6%, screening of women with DNA amplification assay and treatment of positive patients with a single oral dose of azithromycin given under supervision in the clinic was the most cost-effective intervention strategy. At greater prevalences, screening with enzyme immunoassay also generated savings and improved the cure rates compared with no screening, but such screening was less cost-effective than screening with a DNA amplification assay. Compared with no intervention, tissue cell culture is cost-effective only when the prevalence of infection is greater than 14%. Compared with the azithromycin regimen, the standard 7-day, twice-daily doxycycline regimen resulted in significantly lower cure rates because of patients' poor compliance with this regimen. CONCLUSION: For asymptomatic female carriers of C. trachomatis, screening with a DNA amplification assay combined with the single-dose azithromycin treatment of positive patients is the most cost-effective strategy when the prevalence is 6%. When the prevalence is lower than 6%, the decision to choose a competing strategy depends on the physician's view of the value of preventing an illness caused by untreated chlamydial infection. (Less)
Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Internal Medicine
volume
124
issue
1 Pt 1
pages
1 - 7
publisher
American College of Physicians
external identifiers
  • pmid:7503471
  • scopus:0030069817
ISSN
0003-4819
language
English
LU publication?
no
id
88fd6f91-4a42-4f46-b518-8df086ac603c (old id 1110988)
alternative location
http://www.annals.org/cgi/content/full/124/1_Part_1/1
date added to LUP
2008-07-23 10:27:07
date last changed
2017-08-20 03:38:54
@article{88fd6f91-4a42-4f46-b518-8df086ac603c,
  abstract     = {OBJECTIVE: To assess the cost-effectiveness of identifying and treating asymptomatic female carriers of Chlamydia trachomatis. DESIGN: Cost-effectiveness analysis based on previously reported cohort analytic studies and average salaries and costs of medical care in Sweden. SETTING: Women attending youth, family planning, and gynecology clinics. PARTICIPANTS: 1000 women and their male sex partners. INTERVENTION: Screening with tissue cell culture, confirmed enzyme immunoassay, and DNA amplification assays based on either polymerase chain reaction or ligase chain reaction was compared with no screening (no treatment and no tracing of sexual contacts). The effect of antibiotic regimens on the outcome of the screening strategies was also evaluated. RESULTS: When the prevalence of chlamydial infection exceeded 6%, screening of women with DNA amplification assay and treatment of positive patients with a single oral dose of azithromycin given under supervision in the clinic was the most cost-effective intervention strategy. At greater prevalences, screening with enzyme immunoassay also generated savings and improved the cure rates compared with no screening, but such screening was less cost-effective than screening with a DNA amplification assay. Compared with no intervention, tissue cell culture is cost-effective only when the prevalence of infection is greater than 14%. Compared with the azithromycin regimen, the standard 7-day, twice-daily doxycycline regimen resulted in significantly lower cure rates because of patients' poor compliance with this regimen. CONCLUSION: For asymptomatic female carriers of C. trachomatis, screening with a DNA amplification assay combined with the single-dose azithromycin treatment of positive patients is the most cost-effective strategy when the prevalence is 6%. When the prevalence is lower than 6%, the decision to choose a competing strategy depends on the physician's view of the value of preventing an illness caused by untreated chlamydial infection.},
  author       = {Genc, Mehmet and Mårdh, Per-Anders},
  issn         = {0003-4819},
  language     = {eng},
  number       = {1 Pt 1},
  pages        = {1--7},
  publisher    = {American College of Physicians},
  series       = {Annals of Internal Medicine},
  title        = {A cost-effectiveness analysis of screening and treatment for Chlamydia trachomatis infection in asymptomatic women},
  volume       = {124},
  year         = {1996},
}