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

Obstet Gynecol. 1998 Aug;92(2):292-8. doi: 10.1016/s0029-7844(98)00167-7.


Objective: To perform a cost-benefit analysis of a Chlamydia trachomatis screening program based on first-void urine testing of asymptomatic women using a polymerase chain reaction (PCR) test.

Methods: A decision tree was developed. Selected variables based on assumptions were subjected to sensitivity analyses to make the model accurate and defensible.

Results: Screening for chlamydial infections using the PCR test was shown to be cost-effective even in low-prevalence populations. Compared with a symptom-driven no-screening situation, a universal C trachomatis screening program using the PCR test would save money, in terms of direct cost, when the baseline prevalence of C trachomatis infection exceeds 3.9%.

Conclusion: Cost analyses are still rare among trials that compare pharmacologic or procedural health care interventions. Socioeconomic studies linking secondary prevention of C trachomatis infection and infertility and adverse pregnancy outcome are needed to convince public health authorities of the need for and the benefit of such programs.

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia trachomatis / isolation & purification*
  • Cost-Benefit Analysis
  • Decision Trees
  • Female
  • Humans
  • Mass Screening / economics*
  • Middle Aged
  • Polymerase Chain Reaction
  • Sensitivity and Specificity
  • Urine / microbiology*