Cost and effectiveness of chlamydia screening among male military recruits

Markov modeling of complications averted through notification of prior female partners

Remington L. Nevin, Eric E. Shuping, Kevin Frick, Joel C. Gaydos, Charlotte A Gaydos

Research output: Contribution to journalArticle

Abstract

Background: Despite rising rates of female screening, a high economic burden remains associated with Chlamydia infection from high rates of undetected asymptomatic disease and its associated sequelae of pelvic inflammatory disease (PID) and chronic pelvic pain (CP). Males comprise the majority of US military recruits and represent an ideal population in which to achieve identification and interruption of sexually transmitted infection among infected partners through mass tandem screening. Methods: We developed a static decision tree incorporating a calibrated Markov model to predict the differences in healthcare payer direct healthcare costs, cases of PID and CP averted among female partners of male recruits through implementation of either selective (aged 24 and younger) or universal recruit screening policies incorporating partner notification. Results: A policy of selective male screening added $10.30 in direct costs per recruit, whereas universal male screening added an additional $1.60. A policy of selective male screening yielded an incremental cost-effectiveness ratio of $3.7K per case of PID averted, and $7.3K per case of CP averted, whereas universal screening yielded an incremental cost-effectiveness ratio of $8.2K per additional case of PID and $16.4K per additional case of CP averted beyond selective screening. Neither policy was dominant, and results were qualitatively robust to single-variable and probabilistic sensitivity analysis. Conclusions: In consonance with other studies of mass tandem screening, we found both selective and universal male recruit screening cost-effective as compared with other interventions. Our results argue in favor of universal screening of male recruits for Chlamydia infection, linked to partner notification.

Original languageEnglish (US)
Pages (from-to)705-713
Number of pages9
JournalSexually Transmitted Diseases
Volume35
Issue number8
DOIs
StatePublished - Aug 2008

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Chlamydia
Cost-Benefit Analysis
Pelvic Inflammatory Disease
Pelvic Pain
Chronic Pain
Contact Tracing
Chlamydia Infections
Mass Screening
Costs and Cost Analysis
Asymptomatic Diseases
Decision Trees
Sexually Transmitted Diseases
Health Care Costs
Economics
Delivery of Health Care
Population

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Cost and effectiveness of chlamydia screening among male military recruits : Markov modeling of complications averted through notification of prior female partners. / Nevin, Remington L.; Shuping, Eric E.; Frick, Kevin; Gaydos, Joel C.; Gaydos, Charlotte A.

In: Sexually Transmitted Diseases, Vol. 35, No. 8, 08.2008, p. 705-713.

Research output: Contribution to journalArticle

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