Cost-benefit analysis of first-void urine Chlamydia trachomatis screening program

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Economics

Background:

• Chlamydia trachomatis infections are a significant public health concern, often asymptomatic.
• Effective screening strategies are crucial for early detection and prevention of long-term complications.
• Cost-effectiveness of screening programs requires rigorous economic evaluation.

Purpose of the Study:

• To conduct a cost-benefit analysis of a Chlamydia trachomatis screening program.
• To evaluate the economic viability of using first-void urine polymerase chain reaction (PCR) tests for asymptomatic women.
• To determine the prevalence threshold at which universal screening becomes cost-effective.

Main Methods:

• A decision tree model was developed to analyze costs and benefits.
• Sensitivity analyses were performed on key variables to ensure model robustness.
• The analysis compared a universal PCR screening program to a no-screening, symptom-driven approach.

Main Results:

• Chlamydia trachomatis screening using PCR is cost-effective, even in populations with low prevalence.
• A universal PCR screening program for C. trachomatis can be cost-saving compared to no screening.
• Cost-effectiveness is achieved when the baseline prevalence of C. trachomatis infection surpasses 3.9%.

Conclusions:

• Cost-effectiveness analyses are underrepresented in healthcare intervention trials.
• Further socioeconomic research is needed to link C. trachomatis prevention to reduced infertility and adverse pregnancy outcomes.
• Evidence is required to support public health authorities in implementing and recognizing the benefits of C. trachomatis screening programs.