A cost-effectiveness evaluation of a jail-based chlamydia screening program for men and its impact on their partners in the community.
BACKGROUND
Few cost-effectiveness evaluations of screening men in jails for chlamydia have been published, and none have evaluated the cost-effectiveness of providing partner notification services to the partners of chlamydia-infected inmates.


OBJECTIVE
The goal of this study was to evaluate the cost-effectiveness of the chlamydia screening and partner notification programs for men conducted by a Massachusetts jail compared with 3 hypothetical alternatives.


METHODS
Using jail cost and testing data, we used decision analyses to compare the cost and effectiveness of universal screening, age-based screening with 2 age cutoffs, and testing of symptomatic inmates at intake using treated cases of chlamydia and gonorrhea as the primary outcome. We also evaluated the cost-effectiveness of adding partner notification to these alternatives.


RESULTS
Universal screening was the most effective and expensive alternative. Age-based screening would have identified slightly fewer cases at half the cost of universal screening. The net cost of partner notification was low. Assuming high sequelae costs in female partners made partner notification a cost-saving intervention.


CONCLUSIONS
Age-based screening could lower costs without substantially sacrificing effectiveness. Notifying partners of infected inmates was a cost-effective adjunct to screening inmates.
Gift
Thomas L
TL
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. tgift@cdc.gov
Lincoln
Thomas
T
Tuthill
Robert
R
Whelan
Michael
M
Briggs
L Patricia
LP
Conklin
Thomas
T
Irwin
Kathleen L
KL
D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology / Q000517:prevention & control*; D016358:Contact Tracing / Q000191:economics*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008404:Massachusetts / Q000453:epidemiology; D011329:Prisoners