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The estimated lifetime quality-adjusted life-years lost due to chlamydia, gonorrhea, and trichomoniasis in the United States in 2018.
Journal of Infectious Diseases 2023 Februrary 18
OBJECTIVES: We quantified the quality-adjusted life-years (QALYs) lost attributable to chlamydia, gonorrhea, and trichomoniasis in the US, by sex and age group.
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.
FINDINGS: The estimated total discounted lifetime QALYs lost for men and women, respectively, due to infections acquired in 2018, were 1,541 (95% uncertainty interval: 186, 6,358) and 111,872 (29,777, 267,404) for chlamydia, 989 (127, 3,720) and 12,112 (2,410, 33,895) for gonorrhea, and 386 (30, 1,851) and 4,576 (13, 30,355) for trichomoniasis. Total QALYs lost were highest among women ages 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 three sexually transmitted infections cause substantial health losses in the US, 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 STI interventions.
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.
FINDINGS: The estimated total discounted lifetime QALYs lost for men and women, respectively, due to infections acquired in 2018, were 1,541 (95% uncertainty interval: 186, 6,358) and 111,872 (29,777, 267,404) for chlamydia, 989 (127, 3,720) and 12,112 (2,410, 33,895) for gonorrhea, and 386 (30, 1,851) and 4,576 (13, 30,355) for trichomoniasis. Total QALYs lost were highest among women ages 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 three sexually transmitted infections cause substantial health losses in the US, 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 STI interventions.
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