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Urine based screening for asymptomatic/undiagnosed genital chlamydial infection in young people visiting the accident and emergency department is feasible, acceptable, and can be epidemiologically helpful
  1. T Aldeen1,
  2. A Haghdoost2,
  3. P Hay1
  1. 1Department of Genitourinary Medicine, St George’s Hospital, London, UK
  2. 2Department of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to:
 Dr T Aldeen, Department of Genitourinary Medicine, Courtyard Clinic, St George’s Hospital, Blackshaw Road, London SWI7 0QT, UK; 
 tdeen2000{at}hotmail.com

Abstract

Objective: To assess the acceptability and the feasibility of urine based Chlamydia trachomatis screening in asymptomatic young people aged 16–35 years attending an inner city accident and emergency (A&E) department.

Design: Cross sectional study.

Setting: A&E department in a teaching hospital, in south London, UK.

Method: From July to November 2001 a urine based chlamydia screening test was offered to 719 consecutive A&E attendees aged 16–35 years and their companions. Participants were given an information sheet and were asked to complete a demographic and sexual health questionnaire. Following informed consent, eligible participants provided first pass urine specimens. Specimens were tested for C trachomatis using nucleic acid amplification.

Results: Of the A&E attendees asked, 76.5% (550/719) agreed to participate. Prevalence of genital chlamydial infection was 4.2% (18/432; 95% confidence interval (CI) 2.5 to 6.6). 12 of the positive participants (66.7%; 95% CI 40.99 to 86.65) were women, of whom seven were Afro-Caribbean. Nine of the chlamydia positive participants (50%; 95% CI 26.0 to 73.9) were aged 25 years. Three of the positive urine specimens were from companions, of whom a total of 143 were screened. All the positive participants were contactable, and were offered treatment.

Conclusion: Urine based screening for undiagnosed genital chlamydial infection in the A&E department was acceptable and feasible. The department provides a unique site for screening young patients and companions, men and women.

  • chlamydia screening
  • accident and emergency department

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