An economic evaluation of a school-based sexually transmitted disease screening program

Sex Transm Dis. 2002 Dec;29(12):737-45. doi: 10.1097/00007435-200212000-00001.


Background: A school-based sexually transmitted disease (STD) screening program was implemented in eight New Orleans public high schools to detect chlamydia and gonorrhea.

Goal: The goal was to assess the incremental cost-effectiveness of replacing non-school-based screening with the school-based screening program.

Study design: A decision-analysis model was constructed to compare costs and cases of expected pelvic inflammatory disease (PID) in the school-based screening scenario versus a non-school-based screening scenario. Cost-effectiveness was quantified and measured as cost per case of PID prevented.

Results: Under base-case assumptions, at an intervention cost of $86,449, the school screening program prevented an estimated 38 cases of PID, as well as $119,866 in treatment costs for PID and its sequelae, resulting in savings of $1524 per case of PID prevented. Results remained cost-saving over a reasonable range of model parameter estimates.

Conclusions: The New Orleans school-based chlamydia screening program was cost-effective and cost-saving and could be cost-effective in other settings. School-based screening programs of this type are likely to be a cost-effective use of public funds and can reduce the burden of STDs among adolescents.

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis
  • Chlamydia Infections / economics
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control*
  • Cost-Benefit Analysis
  • Decision Trees
  • Female
  • Gonorrhea / diagnosis
  • Gonorrhea / economics
  • Gonorrhea / epidemiology
  • Gonorrhea / prevention & control*
  • Humans
  • Louisiana / epidemiology
  • Male
  • Mass Screening / economics*
  • Mass Screening / standards
  • Pelvic Inflammatory Disease / diagnosis
  • Pelvic Inflammatory Disease / economics
  • Pelvic Inflammatory Disease / epidemiology
  • Pelvic Inflammatory Disease / prevention & control*
  • Prevalence
  • Retrospective Studies
  • School Health Services / economics*
  • Sensitivity and Specificity