Establishing the National Chlamydia Screening Programme in England: results from the first full year of screening
- D S LaMontagne1,
- K A Fenton1,
- S Randall2,
- S Anderson3,
- P Carter3,
- on behalf of the National Chlamydia Screening Steering Group
- 1HIV and Sexually Transmitted Infections Department, Health Protection Agency, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK
- 2Department of Health, Sexual Health and Substance Misuse Team, Room 580D, Skipton House, 80 London Road, London, and Ella Gordon Unit, St Mary’s Hospital, Portsmouth PO3 6AD, UK
- 3Department of Health, Sexual Health and Substance Misuse Team, Room 580D, Skipton House, 80 London Road, London SE1 6LH, UK
- Correspondence to: D Scott LaMontagne MPH, FRIPH, CS, Health Protection Agency, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ, UK;
- Accepted 13 August 2004
Background: The phased implementation of the National Chlamydia Screening Programme (NCSP) began in September 2002. The NCSP offers opportunistic screening for chlamydia to women and men under 25 years of age attending clinical and non-clinical screening venues using non-invasive urine or vulvo-vaginal swab samples tested via nucleic acid amplification. This review describes the implementation of the NCSP, reports positivity rates for the first year, and explores risk factors for genital chlamydial infection.
Methods: Cross sectional study of the first year’s screening data from the NCSP. A standardised core dataset for each screening test was collected from 302 screening venues, excluding genitourinary medicine (GUM) clinics, across 10 phase 1 programme areas. We estimated chlamydia positivity by demographic and behavioural characteristics, and investigated factors associated with infection through univariate and multivariate analyses.
Results: Chlamydia positivity among people under 25 years of age screened in non-GUM settings was 10.1% (1538/15 241) in women and 13.3% (156/1172) in men. Risk factors varied by sex: for women—age 16–19, non-white ethnicity, and sexual behaviours were associated with infection; for men—only age 20–24 and non-white ethnicity were associated with infection.
Discussion: In the first phase of the NCSP, 16 413 opportunistic screens among young adults under 25 years of age were performed at non-GUM settings and testing volume increased over time. Rates of disease were similar to those found during the English screening pilot and were comparable to the first year of widespread screening in Sweden and the United States. The screening programme in England will continue to expand as further phases are included, with national coverage anticipated by 2008.
- CDSC, Communicable Disease Surveillance Centre
- GUM, genitourinary medicine
- LCR, ligase chain reaction
- NAATs, nucleic acid amplification tests
- NCSP, National Chlamydia Screening Programme
- PCR, polymerase chain reaction
- PCTs, primary care trusts
- PIAG, patient information advisory group
- PID, pelvic inflammatory disease
- SDA, strand displacement amplification
- TMA, transcription mediated amplification
↵* Even though the Abbott LCx test (Abbott Laboratories, Abbott Park, IL, USA) was withdrawn from the UK market in early 2003, one programme area in phase 1 tested specimens via ligase chain reaction (LCR) from April to August 2003 because of an overstock of available test kits and reagents.
Competing interest: All authors declare no competing interests in the preparation or submission of this manuscript.