Cost-Effectiveness of Chlamydia Screening Strategies
Summary
Chlamydia trachomatis remains the most commonly reported bacterial sexually transmitted infection worldwide, often asymptomatic yet capable of causing pelvic inflammatory disease, infertility and adverse pregnancy outcomes. Economic evaluations of screening programmes integrate clinical effectiveness with cost metrics to inform health-policy decisions. Analyses typically assess the cost per infection averted or cost per quality-adjusted life year (QALY) gained, comparing strategies such as age-restricted screening for 15–24-year-olds, incorporation into routine antenatal care, use of home-collected specimens, on-site testing in educational or correctional institutions and partner notification schemes. Key determinants of value include underlying prevalence, uptake rates, frequency of testing, test and treatment costs, and the perspective adopted (health-care payer versus societal). High-prevalence settings and well-targeted outreach often yield net savings, while in lower-prevalence contexts programmes may require incentives or novel delivery models to achieve acceptable cost-effectiveness thresholds. Incorporating productivity losses and broader intersectoral costs further enriches decision-making by capturing societal impacts beyond direct medical expenditure.
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Cost-Effectiveness of Chlamydia Screening Strategies publication trend
The graph below shows the total number of articles in cost-effectiveness of chlamydia screening strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Cost-effectiveness analysis (CEA): An assessment comparing costs and health outcomes of interventions, expressed as cost per unit of health gain.
Incremental cost-effectiveness ratio (ICER): The additional cost required to achieve one additional unit of health benefit when comparing two interventions.
Quality-adjusted life year (QALY): A composite measure combining survival and quality of life into a single index for use in economic evaluation.
Opportunistic screening: Offering diagnostic testing to individuals attending health services for unrelated reasons.
Societal perspective: An economic evaluation viewpoint that includes all costs and benefits to society, such as productivity losses and informal care, beyond direct health-care expenditures.
References
- Evaluation of Chlamydia trachomatis screening from the perspective of health economics: a systematic review. Frontiers in Public Health (2023).
- Are intersectoral costs considered in economic evaluations of interventions relating to sexually transmitted infections (STIs)? A systematic review. BMC Public Health (2022).
- Near patient chlamydia and gonorrhoea screening and treatment in further education/technical colleges: a cost analysis of the ‘Test n Treat’ feasibility trial. BMC Health Services Research (2020).
- Economic evaluation of the cost of different methods of retesting chlamydia positive individuals in England. BMJ Open (2019).
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