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Cost-effectiveness of Screening for Chlamydia Using DNA Amplification

Mehmet Genç, MD, MS; Marius Domeika, MD; Per-Anders Mårdh, MD, PhD
JAMA. 1994;271(22):1741. doi:10.1001/jama.1994.03510460033017.
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To the Editor.  —Our economic evaluation reported in JAMA demonstrated that screening with enzyme immunoassay (EIA) on first-catch urine testing positive with leukocyte esterase (LE) dipstick (LE-EIA screening), combined with contact tracing and treatment of positive cases with azithromycin, is the most cost-effective intervention strategy focusing on asymptomatic male carriers of Chlamydia trachomatis.1 At the time this evaluation was undertaken, data on the performance of the two recently introduced commercial DNA amplification assays (DAAs) for C trachomatis had not been published. Recently, several published reports demonstrated that these assays, based on either polymerase chain reaction (Amplicor C trachomatis, Roche Molecular Systems, Branchburg, NJ) or ligase chain reaction (Abbott LCR Assay C trachomatis, Abbott Diagnostics, North Chicago, Ill) are significantly more sensitive than the EIA when testing urine for the diagnosis of asymptomatic chlamydial infections in males.2-5 We evaluated the cost-effectiveness of screening with a DAA on LE-positive urine


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