Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies

Emma Honey, C. Augood, I. Russell, A. Stary, B. Stray-Pedersen, Alexander Allan Templeton, J. Paavonen, P. A. Mardh

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Objective: Screening for Chlamydia trachomatis in the lower genital tract may contribute to the prevention of pelvic inflammatory disease in women. The purpose of this review was to critically appraise, and summarise studies of the cost effectiveness of screening for C trachomatis.

Methods: A literature search was conducted on Medline and in Health Star from 1990-2000. Keywords were C trachomatis, screening, cost effectiveness. Bibliographies of reviewed articles were also searched. The population studied was asymptomatic sexually active women under 30 years of age in a primary care setting. The intervention assessed was screening for lower genital tract infection with C trachomatis and the outcomes studied were cases of C trachomatis detected, cases of PID prevented, and associated costs. Studies were assessed using the Drummond criteria for economic evaluations. They were assessed qualitatively as they were too heterogeneous to allow quantitative analysis.

Results: 10 studies were included. All were modelled scenarios and all found screening to be more cost effective than simply testing symptomatic women, although all were based on probabilities that were assumed. Six of the studies focused on DNA based testing, three of them using urine. The models showed screening to be cost effective at prevalences of 3.1-10.0%, and cost saving (overtesting symptomatic women) at a prevalence as low as 1.1%, if age was used as a selection factor and DNA based tests were used in urine samples.

Conclusions: At the prevalence of infection expected in the target population, all studies suggest screening is cost effective. However, the assumptions used in the models have been difficult to confirm and there is a need for more data, particularly on the risk of complications in women with asymptomatic lower tract infection.

Original languageEnglish
Pages (from-to)406-412
Number of pages6
JournalSexually Transmitted Infections
Volume78
Issue number6
DOIs
Publication statusPublished - 2002

Keywords

  • PELVIC INFLAMMATORY DISEASE
  • FAMILY-PLANNING CLINICS
  • BENEFIT-ANALYSIS
  • ASYMPTOMATIC WOMEN
  • GENERAL-PRACTICE
  • INFECTION
  • URINE
  • PREVALENCE
  • RECRUITS
  • CRITERIA

Cite this

Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies. / Honey, Emma; Augood, C.; Russell, I.; Stary, A.; Stray-Pedersen, B.; Templeton, Alexander Allan; Paavonen, J.; Mardh, P. A.

In: Sexually Transmitted Infections, Vol. 78, No. 6, 2002, p. 406-412.

Research output: Contribution to journalArticle

Honey, E, Augood, C, Russell, I, Stary, A, Stray-Pedersen, B, Templeton, AA, Paavonen, J & Mardh, PA 2002, 'Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies', Sexually Transmitted Infections, vol. 78, no. 6, pp. 406-412. https://doi.org/10.1136/sti.78.6.406
Honey, Emma ; Augood, C. ; Russell, I. ; Stary, A. ; Stray-Pedersen, B. ; Templeton, Alexander Allan ; Paavonen, J. ; Mardh, P. A. / Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies. In: Sexually Transmitted Infections. 2002 ; Vol. 78, No. 6. pp. 406-412.
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T1 - Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies

AU - Honey, Emma

AU - Augood, C.

AU - Russell, I.

AU - Stary, A.

AU - Stray-Pedersen, B.

AU - Templeton, Alexander Allan

AU - Paavonen, J.

AU - Mardh, P. A.

PY - 2002

Y1 - 2002

N2 - Objective: Screening for Chlamydia trachomatis in the lower genital tract may contribute to the prevention of pelvic inflammatory disease in women. The purpose of this review was to critically appraise, and summarise studies of the cost effectiveness of screening for C trachomatis.Methods: A literature search was conducted on Medline and in Health Star from 1990-2000. Keywords were C trachomatis, screening, cost effectiveness. Bibliographies of reviewed articles were also searched. The population studied was asymptomatic sexually active women under 30 years of age in a primary care setting. The intervention assessed was screening for lower genital tract infection with C trachomatis and the outcomes studied were cases of C trachomatis detected, cases of PID prevented, and associated costs. Studies were assessed using the Drummond criteria for economic evaluations. They were assessed qualitatively as they were too heterogeneous to allow quantitative analysis.Results: 10 studies were included. All were modelled scenarios and all found screening to be more cost effective than simply testing symptomatic women, although all were based on probabilities that were assumed. Six of the studies focused on DNA based testing, three of them using urine. The models showed screening to be cost effective at prevalences of 3.1-10.0%, and cost saving (overtesting symptomatic women) at a prevalence as low as 1.1%, if age was used as a selection factor and DNA based tests were used in urine samples.Conclusions: At the prevalence of infection expected in the target population, all studies suggest screening is cost effective. However, the assumptions used in the models have been difficult to confirm and there is a need for more data, particularly on the risk of complications in women with asymptomatic lower tract infection.

AB - Objective: Screening for Chlamydia trachomatis in the lower genital tract may contribute to the prevention of pelvic inflammatory disease in women. The purpose of this review was to critically appraise, and summarise studies of the cost effectiveness of screening for C trachomatis.Methods: A literature search was conducted on Medline and in Health Star from 1990-2000. Keywords were C trachomatis, screening, cost effectiveness. Bibliographies of reviewed articles were also searched. The population studied was asymptomatic sexually active women under 30 years of age in a primary care setting. The intervention assessed was screening for lower genital tract infection with C trachomatis and the outcomes studied were cases of C trachomatis detected, cases of PID prevented, and associated costs. Studies were assessed using the Drummond criteria for economic evaluations. They were assessed qualitatively as they were too heterogeneous to allow quantitative analysis.Results: 10 studies were included. All were modelled scenarios and all found screening to be more cost effective than simply testing symptomatic women, although all were based on probabilities that were assumed. Six of the studies focused on DNA based testing, three of them using urine. The models showed screening to be cost effective at prevalences of 3.1-10.0%, and cost saving (overtesting symptomatic women) at a prevalence as low as 1.1%, if age was used as a selection factor and DNA based tests were used in urine samples.Conclusions: At the prevalence of infection expected in the target population, all studies suggest screening is cost effective. However, the assumptions used in the models have been difficult to confirm and there is a need for more data, particularly on the risk of complications in women with asymptomatic lower tract infection.

KW - PELVIC INFLAMMATORY DISEASE

KW - FAMILY-PLANNING CLINICS

KW - BENEFIT-ANALYSIS

KW - ASYMPTOMATIC WOMEN

KW - GENERAL-PRACTICE

KW - INFECTION

KW - URINE

KW - PREVALENCE

KW - RECRUITS

KW - CRITERIA

U2 - 10.1136/sti.78.6.406

DO - 10.1136/sti.78.6.406

M3 - Article

VL - 78

SP - 406

EP - 412

JO - Sexually Transmitted Infections

JF - Sexually Transmitted Infections

SN - 1368-4973

IS - 6

ER -