{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T09:15:23Z","timestamp":1788513323245,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:00:00Z","timestamp":1786147200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001316","name":"Abbott Laboratories","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001316","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Trichomonas vaginalis, the most common nonviral sexually transmitted infection among women, is associated with multiple adverse health outcomes. Screening asymptomatic women is not recommended, except among women with human immunodeficiency virus (HIV). We aimed to evaluate the cost-effectiveness of T. vaginalis testing and screening strategies among asymptomatic and symptomatic women, respectively, in US primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision-tree model to evaluate 11 testing\/screening strategies (using combinations of wet mount microscopy, rapid antigen testing, and T. vaginalis nucleic acid amplification test [NAAT]) for a hypothetical cohort of 8000 women aged 15\u201359 presenting to US primary care clinics in 2023. We estimated the risk, societal economic burden, and quality-adjusted life year (QALY) losses for trichomonas sequelae\u2014preterm birth, low birthweight, premature rupture of membranes, HIV infection, and cervical cancer\u2014over the cohort's lifetime.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adding T. vaginalis NAAT to wet mount for symptomatic women provided 0.3 additional QALYs at an incremental cost of $24 785 (ICER: $83 097\/QALY). Adding NAAT to rapid antigen testing for symptomatic women yielded 0.1 additional QALYs at an incremental cost of $35 628 (ICER: $324 617\/QALY). Screening asymptomatic women with NAAT cost $403 541\/QALY.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incorporating NAAT into current testing practices for symptomatic women improved health outcomes but increased costs. At a willingness-to-pay threshold of $100 000\/QALY, adding NAAT to wet mount for symptomatic women was cost-effective, whereas adding NAAT to rapid antigen testing was not. Universal NAAT screening among asymptomatic women was also not cost-effective, suggesting that broader screening strategies may require substantially higher willingness-to-pay thresholds to be economically justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag465","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T11:55:22Z","timestamp":1786017322000},"source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of Testing and Screening Strategies for Trichomoniasis Among Asymptomatic and Symptomatic Women in US Outpatient Clinical Settings"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9131-751X","authenticated-orcid":false,"given":"Rong","family":"Rong","sequence":"first","affiliation":[{"name":"Department of Health Policy and Management, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University , New Orleans, Louisiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5438-9312","authenticated-orcid":false,"given":"Charles","family":"Stoecker","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University , New Orleans, Louisiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2038-9151","authenticated-orcid":false,"given":"Patricia J","family":"Kissinger","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Celia Scott Weatherhead School of Public Health and Tropical Medicine, Tulane University , New Orleans, Louisiana ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-3858","authenticated-orcid":false,"given":"Christina A","family":"Muzny","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham , Birmingham, Alabama ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"key":"2026090404361156800_ciag465-B1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/OLQ.0000000000001383","article-title":"Incidence and prevalence of Trichomonas vaginalis infection among persons aged 15 to 59 years: United States, 2018","volume":"48","author":"Lewis","year":"2021","journal-title":"Sexual Trans Dis"},{"key":"2026090404361156800_ciag465-B2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7004a1","article-title":"Sexually transmitted infections treatment guidelines, 2021","volume":"70","author":"Workowski","year":"2021","journal-title":"MMWR Recomm Rep"},{"key":"2026090404361156800_ciag465-B3","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1097\/00007435-199707000-00008","article-title":"Trichomonas vaginalis associated with low birth weight and preterm delivery. 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