Should asymptomatic men be included in chlamydia screening programs? Cost-effectiveness of chlamydia screening among male and female entrants to a national job training program

被引:15
作者
Blake, Diane R. [1 ]
Quinn, Thomas C. [2 ,3 ]
Gaydos, Charlotte A. [2 ]
机构
[1] Univ Massachusetts, Sch Med, Dept Pediat, Worcester, MA 01655 USA
[2] Johns Hopkins Sch Med, Dept Med, Baltimore, MD USA
[3] NIAID, NIH, Bethesda, MD 20892 USA
关键词
D O I
10.1097/OLQ.0b013e31814b86f5
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objective: To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program. Study Design: Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervileal DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening. Results: Universal endocervical NAAT screening of Women and universal urine NAAT screening of men Were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men. Conclusions: Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia
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页码:91 / 101
页数:11
相关论文
共 96 条
[1]   SCREENING URINE SAMPLES BY LEUKOCYTE ESTERASE TEST AND LIGASE CHAIN-REACTION FOR CHLAMYDIAL INFECTIONS AMONG ASYMPTOMATIC MEN [J].
ANESTAD, G ;
BERDAL, BP ;
SCHEEL, O ;
MUNDAL, R ;
ODINSEN, O ;
SKAUG, K ;
KHALIL, OS ;
PLIER, P ;
LEE, H .
JOURNAL OF CLINICAL MICROBIOLOGY, 1995, 33 (09) :2483-2484
[2]  
[Anonymous], 1997, HIDD EP CONFR SEX TR
[3]   Patterns of Chlamydia trachomatis testing and follow-up at a university hospital medical center [J].
Bachmann, LH ;
Richey, CM ;
Waites, K ;
Schwebke, JR ;
Hook, EW .
SEXUALLY TRANSMITTED DISEASES, 1999, 26 (09) :496-499
[4]   DETECTION OF CHLAMYDIA-TRACHOMATIS IN URINE SPECIMENS FROM WOMEN BY LIGASE CHAIN-REACTION [J].
BASSIRI, M ;
HU, HY ;
DOMEIKA, MA ;
BURCZAK, J ;
SVENSSON, LO ;
LEE, HH ;
MARDH, PA .
JOURNAL OF CLINICAL MICROBIOLOGY, 1995, 33 (04) :898-900
[5]   Head-to-head multicenter comparison of DNA probe and nucleic acid amplification tests for Chlamydia trachomatis infection in women performed with an improved reference standard [J].
Black, CM ;
Marrazzo, J ;
Johnson, RE ;
Hook, EW ;
Jones, RB ;
Green, TA ;
Schachter, J ;
Stamm, WE ;
Bolan, G ;
Louis, MES ;
Martin, DH .
JOURNAL OF CLINICAL MICROBIOLOGY, 2002, 40 (10) :3757-3763
[6]   Performance of urine leukocyte esterase in asymptomatic male youth: Another look with nucleic acid amplification testing as the gold standard for Chlamydia detection [J].
Blake, DR ;
Lemay, CA ;
Gaydos, CA ;
Quinn, TC .
JOURNAL OF ADOLESCENT HEALTH, 2005, 36 (04) :337-341
[7]   Cost-effectiveness analysis of screening adolescent males for chlamydia on admission to detention [J].
Blake, DR ;
Gaydos, CA ;
Quinn, TC .
SEXUALLY TRANSMITTED DISEASES, 2004, 31 (02) :85-95
[8]   Improving participation in chlamydia screening programs - Perspectives of high-risk youth [J].
Blake, DR ;
Kearney, MH ;
Oakes, JM ;
Druker, SK ;
Bibace, R .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2003, 157 (06) :523-529
[9]   Determinants of detained male youth's willingness to be tested for chlamydia [J].
Blake, DR ;
Fletcher, KE ;
Fortenberry, JD ;
Rosenthal, SL ;
Felice, ME .
JOURNAL OF ADOLESCENT HEALTH, 2003, 32 (02) :144-145
[10]  
BLAKE DR, 2004, 2004 NAT STD PREV C