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

• Published in: International journal of STD & AIDS 2004-12, Vol.15 (12), p.797-802
• Main Authors: VAN BERGEN, Jan E. A. M, POSTMA, Maarten J, PEERBOOMS, Paul G. H, SPANGENBERG, Arie C, TJEN-A-TAK, Jessica, BINDELS, Patrick J. E
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; AIDS/HIV; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Chlamydia Infections - diagnosis; Chlamydia Infections - economics; Chlamydia Infections - epidemiology; Chlamydia Infections - prevention & control; Chlamydia trachomatis; Chlamydia trachomatis - isolation & purification; Cost-Benefit Analysis; Epidemiology. Vaccinations; Female; General aspects; Human bacterial diseases; Humans; Infectious diseases; Mass Screening - economics; Medical sciences; Netherlands; Pelvic Inflammatory Disease - economics; Pelvic Inflammatory Disease - epidemiology; Pelvic Inflammatory Disease - prevention & control; Pharmacy; Postal Service; Primary Health Care; Program Evaluation; Urine - microbiology
• ISSN: 0956-4624; 1758-1052
• DOI: 10.1258/0956462042563765

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 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.