ORIGINAL ARTICLE

Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases

J M Pimenta¹, M Catchpole¹, P A Rogers², J Hopwood³, S Randall⁴, H Mallinson⁵, E Perkins⁶, N Jackson⁷, C Carlisle⁸, G Hewitt⁹, G Underhill⁹, T Gleave³, L McLean¹⁰, A Ghosh¹¹, J Tobin¹² and V Harindra¹³

¹ PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
² PHLS Statistics Unit
³ Chlamydia Pilot Office, Evidence-based Practice Unit, St Catherine’s Hospital, Church Road, Birkenhead, Wirral, L42 0LQ, UK
⁴ Ella Gordon Unit, St Mary’s Hospital, Milton Road, Portsmouth PO3 6AD, UK
⁵ Liverpool Public Health Laboratory, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK
⁶ Health and Community Care Research Unit, University of Liverpool, Thompson Yates Building, The Quadrangle, Brownlow Hill, Liverpool L69 3GB, UK
⁷ Conway Smith Rose, 60 Charlotte Street, London W1P 2AX, UK
⁸ School of Nursing and Midwifery, The University of Glasgow, 59 Oakfield Avenue, Glasgow G12 8LW, UK
⁹ Portsmouth Public Health Laboratory, St Mary’s Hospital (East Wing), Milton Road, Portsmouth PO3 6AQ, UK
¹⁰ Chlamydia Pilot Office, Ella Gordon Unit, St. Mary’s Hospital, Milton Road, Portsmouth PO3 6AD, UK
¹¹ Department of GU Medicine, Arrowe Park Hospital, Upton, Wirral, CH49 5PE, UK
¹² Department of GU Medicine, St. Mary’s Hospital, Milton Road, Portsmouth PO3 6AD, UK
¹³ Department of GU Medicine, St Mary’s Hospital, Milton Road, Portsmouth PO3 6AD, UK

Correspondence to:
Correspondence to:
Dr Mike Catchpole; PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 54Q, UK;
mcatchpole{at}phls.org.uk

Objectives: To determine the prevalence and treatment outcomes among young women screened opportunistically for genital Chlamydia trachomatis and to evaluate the impact of screening in those participating.

Design: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples, tested by ligase chain reaction (LCR). In-depth interviews were used for programme evaluation.

Setting: Screening was offered in two health authorities at general practice, family planning, genitourinary medicine (GUM), adolescent sexual health, termination of pregnancy clinics and women’s services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics).

Main participants: Sexually active women (16–24 years) attending for any reason.

Main outcome measures: Screening data: prevalence of infection by age and healthcare setting; proportion of positive patients attending for treatment. Evaluation data: participants’ attitudes and views towards screening and follow up.

Results: In total, 16 930 women (16–24 years) were screened. Prevalence was higher in younger women (16–20) than those aged 21–24 years and was highly variable at different healthcare settings (range 3.4%–17.6%). Prevalence was approximately 9% in general practice. The role of the project health advisers in managing results and coordinating treatment of positive individuals was essential; the vast majority of all positives were known to be treated. Women felt that screening was beneficial. Improving awareness and education about sexually transmitted infections is required to alleviate negative reactions associated with testing positive for infection.

Conclusions: Prevalence of infection outside GUM clinics is substantial and opportunistic screening using urine samples is an acceptable method of reaching individuals with infection who do not normally present at specialist clinics.

Keywords: screening; chlamydial infection; urine testing; healthcare settings

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Notice of redundent publication

R Miller, H Ward, M Catchpole, G Underhill, G Hewitt, S Randall, J Tobin, and V Harindra
Sex Transm Inf 2004 80: 254. [Extract] [Full Text] [PDF]

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