title: Should asymptomatic men be included in chlamydia screening programs?   Cost-effectiveness of chlamydia screening among male and female entrants to a national job training program.
abstract: OBJECTIVE
  To compare the cost-effectiveness of various chlamydia screening strategies within a population of male and female youth entering a national job training program.
  
  
  METHODS
  Cost-effectiveness analysis of various chlamydia screening strategies among a cohort of 4000 female and male New England job training students. Strategies for women include (a) no screening, (b) universal endocervical DNA probe screening, (c) universal urine based NAAT screening, and (d) universal endocervical NAAT screening. Strategies for men include (a) no screening, (b) selective urine NAAT screening of leukocyte esterase (LE)-positive urines, and (c) universal urine-based NAAT screening.
  
  
  RESULTS
  Universal endocervical NAAT screening of women and universal urine NAAT screening of men were the most effective and cost-effective strategies individually and in combination. Endocervical NAAT screening of women prevented 23 more cases of PID and saved $27,000 more than endocervical DNA probe screening. Likewise, universal urine NAAT screening of men prevented 21 more cases of PID in their female partners and saved $16,000 more than selective urine NAAT screening of LE positive men.
  
  
  CONCLUSIONS
  Use of a sensitive NAAT to screen both men and women for chlamydia upon entry to a National Job Training Program is cost-effective, cost-saving, and provides a public health opportunity to substantially reduce chlamydia infections among youth at risk for sexually transmitted diseases.
authors.affiliation: Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA. Diane.Blake@umassmed.edu
authors.forename: Diane R
authors.initials: DR
authors.lastname: Blake
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control* / Q000652:urine; D002692:Chlamydia trachomatis; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000706:statistics & numerical data; D018579:Patient Selection; D014481:United States / Q000453:epidemiology; D016482:Urinalysis; D014626:Vaginal Smears