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Maximising the effectiveness of the National Chlamydia Screening Programme in England: should we routinely retest positives?
  1. Sarah C Woodhall1,
  2. Katherine M E Turner2,
  3. Gwenda Hughes1
  1. 1HIV & STI Department, Health Protection Agency, London, UK
  2. 2School of Social and Community Medicine, University of Bristol, Bristol, UK
  1. Correspondence to Sarah C Woodhall, HIV & STI Department, Health Protection Agency, 61 Colindale Avenue, London, NW9 5EQ, UK; sarah.woodhall{at}hpa.org.uk

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Realising the individual and potential population benefits of any chlamydia screening programme depends on good case management. At the very least, this should include the provision of effective and timely antibiotic treatment, finding and treating infected sexual partner(s), and the provision of condoms and safer sex advice.1–3 The papers in this issue and several previously published studies lead us to question whether retesting of people who test positive should also be a routine part of clinical practice. Several countries already recommend retesting 3–12 months after a chlamydia diagnosis.4–7 In England, the National Chlamydia Screening Programme (NCSP) recommends that sexually active young adults be tested annually and on change of sexual partner, but there is no recommendation to routinely retest positives more frequently.3 Should there be?

The clinical arguments for retesting are strong. First, we know from prospective8–11 and passive12 ,13 follow-up studies that individuals who test positive for chlamydia are at considerably higher risk of subsequent chlamydia infection than those who test negative. Retesting could therefore lead to considerably greater numbers of infections being diagnosed and treated. In a …

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