Probabilities of consequences of lower tract infection used in the economic evaluations
| Study ID | Consequences included | Probabilities (amongst uncured Ct* infection) | Test | Discounted | Cost effective at prevalence | Cost saved | |
|---|---|---|---|---|---|---|---|
| *Chlamydia trachomatis | |||||||
| 1 | Howell et al24 (1999) | PID | 30% (40% symptomatic) | LCR urine | 3% | Age based testing less than 25 if prevalence less than 9% or universal treatment in high prevalence groups | $800/PID |
| Chronic pelvic pain | 18% (of PID) | 1 year | |||||
| 2 | Howell et al22 (1998) | PID | 30% symptomatic | Comparing tests | 3% | Yes | $3689/PID |
| Chronic pelvic pain | 18% (of PID) | ||||||
| Ectopic | 7.8% (of PID) | ||||||
| Infertility | 12% (25% treated) | ||||||
| Urethritis | 40% of 68% | ||||||
| Epididymitis | 2% | ||||||
| Neonatal conjunctivitis and pneumonia | 10% and 20% respectively | ||||||
| 3 | Howell et al23 (1998) | PID | 30% (40% symptomatic) | Urine based | 3% | Age based in FPC if less than 30 years if less than 10.2 prevalence | $3585/PID |
| Chronic pelvic pain | 18% (of PID) | NAA | 1 year for symptomatic PID | ||||
| Ectopic | 7.8% (of PID) | Cost saving as long as prevalence greater than 1.1% | |||||
| Infertility | 12% (25% treated) | ||||||
| Urethritis | 40% of 68% | Universal if prevalence greater than 10.2% | |||||
| Epididymitis | 2% | ||||||
| Neonatal conjunctivitis and pneumonia | 10% and 20% respectively | ||||||
| 4 | Paavonen et al21 (1998) | Among Ct* positives | NAA on urine | 4% | Universal screening in FPC at 3.9% prevalence if uptake 75% using DNA based test assuming 90% return rate | 50% of sequelae prevented cost $45 per case Ct* detected | |
| PID | 60% (20% symptomatic) | 3 years after PID for chronic pelvic pain | |||||
| Infertility | 20% (of PID) | 5 years for ectopic | |||||
| Ectopic | 25% (of PID) | 10 years for infertility | |||||
| 5 | Marazzo et al19 (1997) | PID | 15–40% | EIA in several settings | 5% | Universal screening with EIA if prevalence greater than 3.1% in FPC | $1100/PID |
| Chronic pelvic pain | 15–20% (of PID) | 10 years for infertility | |||||
| Infertility | 10–20% (of PID) | 5 years for ectopic and chronic pelvic pain | |||||
| Epididymitis | 1% | ||||||
| Ectopic | 5–10% (of PID) | ||||||
| 6 | Genc and Mardh18 | PID | Pooled probability of consequence | NAA | 5–10% | Universal screening cost effective in asymptomatic women at FPC with DNA based test at 6% prevalence if treated with azithromycin | |
| (1996) | Chronic pelvic pain | 5–10 years for all complications | |||||
| Ectopic | |||||||
| Infertility | |||||||
| Urethritis | |||||||
| Epididymitis | |||||||
| Neonatal conjunctivitis and pneumonia | |||||||
| 7 | Sellors et al17 (1992) | Cervicitis | 20% | EIA | 5% | Selective screening using set criteria in low prevalence <7% populations with EIA effective | |
| PID | 3% (of untreated Ct*) | 8 years | |||||
| Ectopic | 5% | ||||||
| Infertility | 15% | ||||||
| 8 | Buhaug et al15 (1990) | PID | Varied with age | Culture | 5% | Cost effective in general practice in women less than 24 every 2 years | |
| 20% (6–44%) | Time varied with age | ||||||
| Ectopic | 2.5% (of PID) | ||||||
| Infertility | 20% (of PID) (50% treated) | ||||||