Abstract
Chlamydia trachomatis is a common STI that is often asymptomatic, and can only be diagnosed through a screening test. Despite acute infection being asymtpoamtic, long term consequences of untreated CT infection can lead to infertility in men and women, increased risk of ectopic preganancy, and the economic burden of the long-term impacts far outweigh the cost of testing and treatment. Despite this, there is currently no concentrated CT screening programme in the DPRK, a region that is indicated to have high STI rates, including CT. Taking into account prevalency, the geopolitical situation of the DPRK, and the cost per positive test, this paper explores whether or not a CT screening programme would be cost-effective in the DPRK.
Highlights
Treating complications in pregnancy, miscarriage and delivery can have major economic consequences.[1]
With 20% of 357 million people globally diagnosed each year with an Sexually Transmitted Infections (STIs) living in Southeast Asia, 5, 6 it is possible that these high rates are impacting rates of pregnancy complications
EVALUATION Evaluation of ante-natal chlamydia screening The cost-effectiveness of a chlamydia screening program depends on the prevalence of the infection within the targeted population and the number of service-users screened; ante-natal chlamydia screening has been shown to be cost effective in high-prevalence areas using nucleic acid amplification tests (NAATs).[26]
Summary
Miscarriage and delivery can have major economic consequences.[1]. Current infrastructure in Southeast Asia, including the DPRK, is not ideal for dealing with the possible scale of the issue,[14] with the commitment of the current stakeholders (MOPH and the UNFPA) to improving testing and treatment as well as improvement in sexual and reproductive health (SRH) in general, there is a good base for both stakeholders to improve SRH, and alleviate the economic burden on the health system of the long-term consequences of chlamydia in the population.
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