Effectiveness and cost-effectiveness of a pharmacy-based screening programme for Chlamydia trachomatis in a high-risk health centre population in Amsterdam using mailed home-collected urine samples

Int J STD AIDS. 2004 Dec;15(12):797-802. doi: 10.1258/0956462042563765.

Abstract

In order to increase case-detection of Chlamydia trachomatis (CT) in a multicultural, low-income and high-CT-prevalence neighbourhood, a novel approach was piloted in collaboration with the pharmacy of the health centre. During a two-year period, women aged 15-29 years who collected their contraceptives at the pharmacy were offered CT-test materials. Home-collected urine could be mailed to the laboratory and the general practitioner received the results. Nine percent of respondents were CT-positive (14% among 15-24 year-olds). There was a strong association with Surinamese/Antillean background. Uptake of the programme was low (27%). Net cost per pelvic inflammatory disease prevented ranged from cost-saving up to 3872 Euros in a low complication rate/high testing cost scenario. Faced with higher risk, but low participation rates, active case-detection of CT-infections in 'high-prevalence-areas' needs a concerted approach by different providers and community organizations, both in secondary and primary prevention. Pharmacists can contribute if proper liaison is made with primary care providers and/or public health services for (partner-)treatment, counselling and comprehensive sexual health care.

MeSH terms

  • Adolescent
  • Adult
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / economics
  • Chlamydia Infections / epidemiology
  • Chlamydia Infections / prevention & control
  • Chlamydia trachomatis / isolation & purification*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Mass Screening / economics*
  • Netherlands
  • Pelvic Inflammatory Disease / economics
  • Pelvic Inflammatory Disease / epidemiology
  • Pelvic Inflammatory Disease / prevention & control
  • Pharmacy*
  • Postal Service
  • Primary Health Care
  • Program Evaluation
  • Urine / microbiology*