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A cost-effectiveness evaluation of a jail-based Chlamydia screening
program for men and its impact on their partners in the community.
Sexually Transmitted Diseases 2006; 33(10):S103-S110.
Gift TL, Lincoln T, Tuthill R, Whelan M, Briggs LP, Conklin T, Irwin
KL.
Abstract
BACKGROUND: Few cost-effectiveness evaluations of screening men in jails for
chlamydia have been published, and none have evaluated the cost-effectiveness
of providing partner notification services to the partners of chlamydia-infected
inmates. GOAL: The goal of this study was to evaluate the cost-effectiveness
of the chlamydia screening and partner notification programs for men conducted
by a Massachusetts jail compared with 3 hypothetical alternatives. STUDY
DESIGN: Using jail cost and testing data, we used decision analyses to compare
the cost and effectiveness of universal screening, age-based screening with
2 age cutoffs, and testing of symptomatic inmates at intake using treated
cases of chlamydia and gonorrhea as the primary outcome. We also evaluated
the cost-effectiveness of adding partner notification to these alternatives.
RESULTS: Universal screening was the most effective and expensive alternative.
Age-based screening would have identified slightly fewer cases at half the
cost of universal screening. The net cost of partner notification was low.
Assuming high sequelae costs in female partners made partner notification
a cost-saving intervention. CONCLUSIONS: Age-based screening could lower
costs without substantially sacrificing effectiveness. Notifying partners
of infected inmates was a cost-effective adjunct to screening inmates.