[Screening for asymptomatic Chlamydia trachomatis infection in pregnancy; cost-effectiveness favorable at a minimum prevalence rate of 3% or more].
OBJECTIVE
To estimate the cost-effectiveness of antenatal screening for Chlamydia trachomatis.


METHODS
Pharmaco-economic model analysis.


METHODS
The risks of C. trachomatis infection during pregnancy and of complications of the infection as well as the cost of screening for complications (pelvic inflammatory disease, chronic pelvic pain, ectopic pregnancy, infertility and neonatal pneumonia) and of treatment were estimated. Assumed were a ligase chain reaction on urine and treatment of identified infected cases with erythromycin or amoxicillin (second choice). Cost-effectiveness was calculated and presented in net direct and indirect costs per major complication averted.


RESULTS
For C. trachomatis prevalences in pregnancy above 4% benefits exceed the costs. For prevalences between 2.82% and 4.00% net costs are positive, but a major complication averted costs less than f 1000.-. Considering sensitivity analysis as well, screening for C. trachomatis at prevalences above 3% costs less than f 1000.-per major complication averted and might even save costs. No recent Dutch data on C. trachomatis prevalence in pregnancy are published however.


CONCLUSIONS
Given the current information, antenatal C. trachomatis screening can be recommended from a pharmaco-economic perspective if C. trachomatis prevalence in pregnancy is 3% or more.
Postma
M J
MJ
Groningen University Institute for Drug Exploration/Groningen Research Institute of Pharmacy, Antonius Deusinglaan 1, 9713 AV Groningen.
Bakker
A
A
Welte
R
R
van Bergen
J E
JE
van den Hoek
J A
JA
de Jong-van den Berg
L T
LT
Jager
J C
JC
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control* / Q000652:urine; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics* / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control* / Q000652:urine; D011295:Prenatal Care / Q000191:economics