Screening for Chlamydia trachomatis in adolescent males: a cost-based decision analysis

Am J Public Health. 1990 May;80(5):545-50. doi: 10.2105/ajph.80.5.545.

Abstract

To evaluate the cost and benefits of screening tests for Chlamydia trachomatis in adolescent males, we developed a decision analysis model and compared the leukocyte esterase urine dipstick test with culture, with direct-smear fluorescent antibody (DFA), and with the option of no screening (no treatment). The leukocyte esterase test has the lowest average cost-per-cure ($51) compared with direct-smear fluorescent antibody ($192) and culture ($414). Compared with the DFA, we estimate that the leukocyte esterase test saves over $9,727 per cohort of 1,000 sexually active adolescent males screened. Sensitivity analyses show the leukocyte esterase test results in a lower cost-per-cure and lower overall costs (per cohort) than culture and direct-smear fluorescent antibody at any prevalence of C. trachomatis infection, and lower overall costs (per cohort) than no screening at prevalences above 21 percent.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Chlamydia Infections / economics
  • Chlamydia Infections / prevention & control*
  • Chlamydia trachomatis / isolation & purification
  • Colony Count, Microbial / economics
  • Cost-Benefit Analysis*
  • Decision Trees
  • Esterases / urine
  • Female
  • Fluorescent Antibody Technique / economics
  • Humans
  • Leukocytes / enzymology
  • Male
  • Mass Screening / economics*
  • Mass Screening / methods
  • Predictive Value of Tests
  • Reagent Kits, Diagnostic / economics
  • United States

Substances

  • Reagent Kits, Diagnostic
  • Esterases