Cost-effectiveness of screening for genital Chlamydia trachomatis

Chlamydia trachomatis is the most common, curable, sexually transmitted disease in many Western countries, leading to severe sequelae, such as infertility and ectopic pregnancy. As most chlamydial infections are asymptomatic, screening programs seem to be an attractive public health measure. MEDLINE, EMBASE, the Health Economic Evaluation Database and the National Health Service Economic Evaluation Database were searched for economic evaluations of Chlamydia trachomatis screening programs. Key factors influencing the cost-effectiveness are identified and assessed, such as screening strategy, test system and treatment regimen. Standard and new methodological approaches for assessing the cost-effectiveness are presented and future developments in the field are predicted. The most cost-effective screening approaches are compared with the recommendations of international guidelines.