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Use of a primary care database to determine trends in genital chlamydia testing, diagnostic episodes and management in UK general practice, 1990–2004
  1. Gwenda Hughes1,
  2. Tim Williams2,
  3. Ian Simms1,
  4. Catherine Mercer3,
  5. Kevin Fenton4,
  6. Jackie Cassell5
  1. 1Department of HIV and STIs, Health Protection Agency Centre for Infections, London, UK
  2. 2General Practice Research Database, Medicines and Healthcare products Regulatory Agency, London, UK
  3. 3Centre for Sexual Health and HIV Research, University College London, London, UK
  4. 4National Center for HIV, STD, and TB Prevention, Centers for Disease Control, Atlanta, Georgia, USA
  5. 5Brighton and Sussex Medical School, Falmer, Brighton, UK
  1. Correspondence to:
 Dr G Hughes
 Department of HIV and STIs, Health Protection Agency Centre for Infections, London NW9 5EQ, UK; gwenda.hughes{at}hpa.org.uk

Abstract

Objective: To determine the extent of testing, diagnostic episodes and management of genital Chlamydia trachomatis (CT) infection in UK primary care using a large primary care database.

Methods: The incidence of CT tests, diagnostic episodes, treatments and referrals was measured for all adult patients in the General Practice Research Database between 1990 and 2004.

Results: Rates of CT testing in those aged 12–64 years in 2004 increased to 1439/100 000 patient years (py) in women but only 74/100 000 py in men. Testing rates were highest among 20–24-year-old women (5.5% tested in 2004), followed by 25–34-year-old women (3.7% tested in 2004). 0.5% of registered 16–24-year-old women were diagnosed as having CT infection in 2004. Three-quarters of patients with a recorded diagnosis of CT had had an appropriate prescription issued in 2004, a proportion that increased from 1990 along with a decrease in referrals to genitourinary medicine. In 2004, general practitioners treated 25.0% of all recorded diagnoses of CT in women and 5.1% of those in men.

Conclusions: Testing for and diagnostic episodes of CT in primary care have increased since 1990. Testing continues disproportionately to target women aged >24 years. Extremely low rates of testing in men, together with high positivity, demonstrate a missed opportunity for diagnosis of CT and contact tracing in general practice.

  • CT, Chlamydia trachomatis
  • GP, general practitioner
  • GPRD, General Practice Research Database
  • GUM, genitourinary medicine
  • NCSP, National Chlamydia Screening Programme
  • OXMIS, Oxford Medical Information System
  • STI, sexually transmitted infection

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Footnotes

  • Published Online First 14 March 2007

  • Competing interests: None.

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