Cost-Effectiveness of Screening Strategies for Gonorrhea Among Females in Private Sector Care

摘要: OBJECTIVE To identify the optimal screening algorithm for gonorrhea infection among females in private sector care, using cost-effectiveness analysis. METHODS We compared 6 strategies decision analysis urine nucleic acid amplification testing a theoretical cohort of 10,000 aged 15-35 years: 1) screen women younger than 25 years; 2) 30 3) years who report any risk (pregnant, drug use, new sexual partner < days); 4) risk; 5) or those and 6) risk. Infection prevalence sensitivity specificity were by direct observation from retrospective attending Baltimore City Sexually Transmitted Disease Clinics between 1999 2002. The main outcome measures untreated cases their sequelae women, transmission to male partner, congenital outcomes, cost prevent case. RESULTS Prevalence was 3.0%. Not would result 300 cases. cost-saving over all strategies. Strategy resulted fewest (82), although 3 most cost-effective Univariate identified threshold 4.75% prevalence, more which became not screening. CONCLUSION Screening is recommended with specific risks populations greater. LEVEL OF EVIDENCE II-2.