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Universal screening or prophylactic treatment for Chlamydia trachomatis infection among women seeking induced abortions: which strategy is more cost-effective?

Chen S, Li J, van den Hoek A

Shandong Provincial Institute of Dermatovenereology, Shandong Provincial Academy of Medicine and sciences, People's Republic of China. Chenshm@public.jn.sd.cn

OBJECTIVE: The objective of this study was to evaluate the cost-effectiveness of universal screening and azithromycin-based prophylaxis against no intervention for Chlamydia trachomatis infection among women seeking induced abortions. METHODS: A decision tree was constructed to evaluate health effects of the program. Cost-effectiveness was estimated for universal screening and azithromycin-based prophylaxis against no intervention with a C. trachomatis test prevalence of 4.8%. RESULTS: Azithromycin-based prophylaxis produced higher cost but prevented 289 cases of pelvic inflammatory disease (PID) for a cost of 397 RMB (U.S. $48) per case of PID prevented over no intervention. Universal screening by polymerase chain reaction test prevented 253 cases of PID at a cost of 3,049 RMB (U.S. $372) per case of PID prevented over no intervention. Azithromycin-based prophylaxis prevented an additional 36 cases of PID, costing 18,239 RMB (US $2,224) less per case of PID prevented over universal screening. CONCLUSIONS: Azithromycin-based prophylaxis provided a cost savings over universal screening for chlamydial infection among women seeking induced abortion.

Published 6 April 2007 in Sex Transm Dis, 34(4): 230-6.
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