The Cost-Effectiveness of Screening Men for Chlamydia trachomatis: A Review of the Literature

Abstract

Studies comparing chlamydia screening in men with chlamydia screening in women may be the most useful for guidance to programs. The studies which compare the 2 generally have found that screening men from the general population is not preferred to screening women from the general population, although 1 study found that screening of men from risk groups can be cost-effective compared with screening women from the general population.

The utility and cost of Chlamydia trachomatis and Neisseria gonorrhoeae screening of a male infertility population

“…The cost of STI screening programs has been addressed in a number of populations (34) but had yet to be conducted in the male infertility population. Although our cost analysis is simplistic, it demonstrates that even if only a fixed cost is evaluated, the cost is significant.…”

Usefulness of quantifying leukocytes in first-voided urine to predict positivity for Chlamydia trachomatis in asymptomatic men at high risk for chlamydial infection

“…Some strategies, including identification of leukocytes in spun FVU or urinary leukocyte esterase testing of unspun FVU prior to detection of C. trachomatis, have been attempted [18]. Automated quantitative urine particle analyzers can test a large number of urine specimens rapidly, and their greater precision has been emphasized compared to that of microscopic examinations [19,20].…”

“…The present study suggested that the quantification of leukocytes in FVU with automated quantitative urine particle analyzers might have good performance for predicting the presence or absence of chlamydial infection. When the threshold value of 12.5 WBCs/ml determined in this study is used and the pre-test probability of C. trachomatis is assumed to range from 5% to 10% in asymptomatic adolescent men [18], the positive and negative predictive values of the quantification of leukocytes in FVU can be calculated to be 28.7% (95% CI, 5.9e51.5%) to 45.9% (95% CI, 23.4e68.3%) and 99.2% (95% CI, 97.2e100%) to 98.4% (95% CI, 95.6e100%), respectively. The post-test probability of the positivity for C. trachomatis in an asymptomatic man in these populations with low prevalence of C. trachomatis infections, who has a negative test result for quantification of leukocytes in FVU with an automated particle analyzer, can be calculated to be 0.8e1.6%.…”

Chlamydia trachomatis Infection and Reproductive Health Outcomes in Women

“…Screening for chlamydia in females aged <25 years has been described as one of the most beneficial and cost-effective preventive services that can be offered in medical practice (58), and has been considered as an A-rated recommended preventive service (strongest recommendation) (93). Screening of men has not been shown to be cost-efficient and, although this practice could prevent many infections in women, its impact on the burden of disease in women by testing young men or specific risk groups is controversial (38,50).…”