The Estimated Lifetime Quality-Adjusted Life-Years Lost Due to Chlamydia, Gonorrhea, and Trichomoniasis in the United States in 2018

• Published in: The Journal of infectious diseases 2023-04, Vol.227 (8), p.1007-1018
• Main Authors: Li, Yunfei, You, Shiying, Lee, Kyueun, Yaesoubi, Reza, Hsu, Katherine, Gift, Thomas L, Chesson, Harrell W, Berruti, Andrés A, Salomon, Joshua A, Rönn, Minttu M
• Format: Article
• Language: English
• Subjects: Chlamydia; Chlamydia Infections - complications; Complications; Female; Gonorrhea; Gonorrhea - complications; Humans; Infections; Major; Male; Quality-Adjusted Life Years; Sensitivity analysis; Sexually transmitted diseases; Sexually Transmitted Diseases - complications; STD; Trichomonas Infections - complications; Trichomonas Infections - epidemiology; Trichomoniasis; United States - epidemiology; Women
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jiad047

Abstract Background Comprehensive evaluation of the quality-adjusted life-years (QALYs) lost attributable to chlamydia, gonorrhea, andtrichomoniasis in the United States is lacking. Methods We adapted a previous probability-tree model to estimate the average number of lifetime QALYs lost due to genital chlamydia, gonorrhea, and trichomoniasis, per incident infection and at the population level, by sex and age group. We conducted multivariate sensitivity analyses to address uncertainty around key parameter values. Results The estimated total discounted lifetime QALYs lost for men and women, respectively, due to infections acquired in 2018, were 1541 (95% uncertainty interval [UI], 186–6358) and 111 872 (95% UI, 29 777–267 404) for chlamydia, 989 (95% UI, 127–3720) and 12 112 (95% UI, 2 410–33 895) for gonorrhea, and 386 (95% UI, 30–1851) and 4576 (95% UI, 13–30 355) for trichomoniasis. Total QALYs lost were highest among women aged 15–24 years with chlamydia. QALYs lost estimates were highly sensitive to disutilities (health losses) of infections and sequelae, and to duration of infections and chronic sequelae for chlamydia and gonorrhea in women. Conclusions The 3 sexually transmitted infections cause substantial health losses in the United States, particularly gonorrhea and chlamydia among women. The estimates of lifetime QALYs lost per infection help to prioritize prevention policies and inform cost-effectiveness analyses of sexually transmitted infection interventions. Chlamydia, gonorrhea, and trichomoniasis cause substantial lifetime quality-adjusted life-years (QALYs) lost in the United States in 2018, particularly among women. The estimates of lifetime QALYs lost per infection help to prioritize prevention policies and inform cost-effectiveness analyses of STI interventions.