Universal screening or prophylactic treatment for Chlamydia trachomatis infection among women seeking induced abortions: which strategy is more cost-effective?
OBJECTIVE
The objective of this study was to evaluate the cost-effectiveness of universal screening and azithromycin-based prophylaxis against no intervention for Chlamydia trachomatis infection among women seeking induced abortions.


METHODS
A decision tree was constructed to evaluate health effects of the program. Cost-effectiveness was estimated for universal screening and azithromycin-based prophylaxis against no intervention with a C. trachomatis test prevalence of 4.8%.


RESULTS
Azithromycin-based prophylaxis produced higher cost but prevented 289 cases of pelvic inflammatory disease (PID) for a cost of 397 RMB (U.S. $48) per case of PID prevented over no intervention. Universal screening by polymerase chain reaction test prevented 253 cases of PID at a cost of 3,049 RMB (U.S. $372) per case of PID prevented over no intervention. Azithromycin-based prophylaxis prevented an additional 36 cases of PID, costing 18,239 RMB (US $2,224) less per case of PID prevented over universal screening.


CONCLUSIONS
Azithromycin-based prophylaxis provided a cost savings over universal screening for chlamydial infection among women seeking induced abortion.
Chen
Shumin
S
Shandong Provincial Institute of Dermatovenereology, Shandong Provincial Academy of Medicine and sciences, People's Republic of China. Chenshm@public.jn.sd.cn
Li
Jianhong
J
van den Hoek
Anneke
A
D000028:Abortion, Induced; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D017963:Azithromycin / Q000008:administration & dosage* / Q000191:economics; D002681:China / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002692:Chlamydia trachomatis; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D014626:Vaginal Smears / Q000191:economics; D014932:Women's Health Services / Q000191:economics
D000900:Anti-Bacterial Agents; D017963:Azithromycin