Searching for sexually transmitted infections by midstream urine pooling after exclusion of urinary tract infection: A cost-effectiveness analysis
Abstract
We aimed to evaluate the cost-effectiveness of screening for sexually transmitted infections (STI), Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis in patients with suspected urinary tract infection (UTI) but negative urine cultures, using a pooled sampling method. A cohort of 200 patients was analyzed. A decision tree model based on cost-effectiveness was used to evaluate the following five diagnostic strategies: (A) no screening;(B) screening only men;(C) screening only women;(D) screening men and women with high leukocyte counts (>70cells/µL);(E) screening all men and women. The pooling method reduced reagent testing costs by 75 %. The most cost-effective strategy was screening men and women with high leukocyte counts, yielding an incremental cost-effectiveness ratio of 489.05euros. STI screening using pooled midstream urine samples in patients with suspected UTI and negative urine cultures is cost-effective, particularly when targeting individuals with high leukocyte counts. This approach optimizes resource use and improves early STI detection.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 200 participants or records.
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