Chlamydia screening for pregnant women aged 16–25 years attending an antenatal service: a cost‐effectiveness study

Abstract

Chlamydia screening for all pregnant women aged 16-25 years during an antenatal visit is cost effective.

Chlamydia sequelae cost estimates used in current economic evaluations: does one-size-fit-all?

“…One22 of the 11 papers selected cited sequelae management costs from previously published papers, so the latter two papers were also included 16 17. For completeness, two more recent papers, one by Looker et al ,28 evaluating cost-effectiveness of chlamydia testing in Scotland, and the other by Ong et al ,20 from an Australian perspective, were also included in our analysis (see figure 1). …”

“…EP was considered by 13/15 papers,12–17 21–27 TFI by 14/15,12–17 21–28 CPP by 9/15,13–17 22–24 26 epididymitis by 12/1512–17 21–23 25–27 and neonatal conjunctivitis/pneumonia by 11/15 12–17 21–23 25 26. The paper by Ong et al ,20 which evaluated antenatal chlamydia screening, also considered low birth weight and postpartum endometritis. As shown in figure 2 there was considerable variation in the reference case cost estimates for each sequela used among the papers considered.…”

“…For CPP, the average value from several papers13–19 was used. Low birth weight and postpartum endometritis were obtained from Ong et al, 20 as they were only considered in this paper. In addition, pregnancy rate (applicable to neonatal complications) was age-specific in Adams et al, 12 so we referred to the 5% reported in Norman et al 13 for an overall estimate (table 1).…”

Should azithromycin 1 g be abandoned as a treatment for bacterial STIs? The case for and against

“…Amoxicillin has a better side effect profile and similar cure rates when compared with erythromycin but, in vitro, can induce latency with the re-emergence of infection after treatment has ended causing concern 34. Chlamydia is at least as common in young pregnant women as their non-pregnant counterparts and new evidence suggests that screening in antenatal clinics is likely cost-effective and possibly cost-saving in some situations 35 36…”

Chlamydia screening in an early pregnancy unit

“…A recent Australian paper suggests that chlamydia screening in pregnant women aged <25 may be cost-effective 1. However, chlamydia testing may not be implemented routinely during antenatal care, and there remains controversy about the relationship of chlamydia in pregnancy with adverse pregnancy outcome 2…”