title: Effectiveness and cost-effectiveness of a pharmacy-based screening programme for Chlamydia trachomatis in a high-risk health centre population in Amsterdam using mailed home-collected urine samples.
abstract: In order to increase case-detection of Chlamydia trachomatis (CT) in a multicultural, low-income and high-CT-prevalence neighbourhood, a novel approach was piloted in collaboration with the pharmacy of the health centre. During a two-year period, women aged 15-29 years who collected their contraceptives at the pharmacy were offered CT-test materials. Home-collected urine could be mailed to the laboratory and the general practitioner received the results. Nine percent of respondents were CT-positive (14% among 15-24 year-olds). There was a strong association with Surinamese/Antillean background. Uptake of the programme was low (27%). Net cost per pelvic inflammatory disease prevented ranged from cost-saving up to 3872 Euros in a low complication rate/high testing cost scenario. Faced with higher risk, but low participation rates, active case-detection of CT-infections in 'high-prevalence-areas' needs a concerted approach by different providers and community organizations, both in secondary and primary prevention. Pharmacists can contribute if proper liaison is made with primary care providers and/or public health services for (partner-)treatment, counselling and comprehensive sexual health care.
authors.affiliation: SoaAids Nederland, Keizersgracht 390-392, 1016 Amsterdam, The Netherlands. jvanbergen@soaaids.nl
authors.forename: Jan E A M
authors.initials: JE
authors.lastname: van Bergen
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Postma
authors.forename: Paul G H
authors.initials: PG
authors.lastname: Peerbooms
authors.forename: Arie C
authors.initials: AC
authors.lastname: Spangenberg
authors.forename: Jessica
authors.initials: J
authors.lastname: Tjen-A-Tak
authors.forename: Patrick J E
authors.initials: PJ
authors.lastname: Bindels
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D009426:Netherlands; D000292:Pelvic Inflammatory Disease / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D010604:Pharmacy; D011177:Postal Service; D011320:Primary Health Care; D015397:Program Evaluation; D014556:Urine / Q000382:microbiology*