Disease Burden Higher for Chlamydia vs Gonorrhea, Trichomoniasis in United States

Results of a study published in The Journal of Infectious Diseases suggest that chlamydia, compared with gonorrhea and trichomoniasis, is associated with the greatest total aggregate quality-adjusted life-years (QALYs) lost nationwide.

Researchers used a modified probability-tree model to estimate the mean number of QALYs lost due to infection with chlamydia, gonorrhea, and trichomoniasis among men and women in the United States in 2018. Data were aggregated to determine the total number of discounted lifetime QALYs lost per incident infection and by age and sex. Multivariate sensitivity analyses were performed to address uncertainty for key parameters.

Overall, the estimated discounted lifetime QALYs lost per 1000 incident infections among men and women (age range, 15-59 years), respectively, were 0.94 (95% uncertainty interval [UI], 0.12-3.85) and 46.98 (95% UI, 12.87-113.27) for chlamydia, 1.43 (95% UI, 0.19-5.48) and 14.22 (95% UI, 3.26-39.14) for gonorrhea, and 0.12 (95% UI, 0.01-0.52) and 1.35 (95% UI, 0.003-10.67) for trichomoniasis.

At the population-level, the estimated discounted lifetime QALYs lost among men and women, respectively, were 1541 (95% UI, 186-6,358) and 111,872 (95% UI, 29,777-267,404) for chlamydia, 989 (95% UI, 127-3720) and 12,112 (95% UI, 2410-33,895) for gonorrhea, and 386 (95% UI, 30-1851) and 4576 (95% UI, 13-30,355) for trichomoniasis.

The researchers observed age- and sex-based variations in lifetime QALYs lost per 1000 person-years for incident chlamydia, gonorrhea, and trichomoniasis infections. Of all 3 sexually transmitted infections (STIs), chlamydia was associated with the highest estimated mean QALYs lost per 1000 py among individuals aged 15 to 24 years and across population subgroups.

Of note, urethritis was the primary contributor to the total QALYs lost among men. In addition, QALYs lost were higher in women vs men for all 3 STIs and across all age groups, and the duration of chronic sequelae was significantly longer for women.

Limitations include potentially insufficient data to accurately determine QALYs lost and the lack of inclusion of QALYs lost associated with STI-associated HIV infection and pregnancy-related adverse STI outcomes.

According to the researchers, “Estimates of lifetime QALYs lost for incident STIs in the US are valuable for informing cost-effectiveness analyses of STI prevention and prioritizing prevention policies.”

Disclosures: Multiple authors declared affiliations with pharmaceutical, biotech, and/or device companies. Please see the original reference for a full list of disclosures.