Repeat chlamydia screening among adolescents: cohort study in a school-based programme in New Orleans
- 1Division of Clinical Epidemiology and Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- 2Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Canada
- 3Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
- Correspondence to Professor Nicola Low, Department of Epidemiology and Public Health, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, CH-3012, Switzerland;
Contributors NL had the idea for the study. NL, MF and MJN designed the study. MJN and SNT provided access to the data. MF conducted the statistical analyses with support from MJN. All contributors helped interpret the data. NL drafted the manuscript. All contributors helped revise the manuscript.
- Accepted 11 May 2012
- Published Online First 6 July 2012
Objectives To describe uptake of chlamydia screening, determine rates of repeated yearly screening and investigate determinants of repeated participation in an organised school-based screening programme.
Methods The authors analysed data from 1995 to 2005 from female and male students in up to 13 schools in New Orleans, Louisiana, USA. The authors calculated proportions of students tested among all enrolled students and among those with parental consent and the percentage of positive chlamydia tests in each school year. The authors used random effects logistic regression to examine the effect of past screening history on subsequent participation.
Results 35 041 students were registered for at least one school year. Overall coverage was >30% in all school years. Among all students registered for 4 years, 10.6% (95% CI 9.3% to 12.0%) of women and 12.7% (95% CI 11.2% to 14.2%) of men had a test every year. Among students with parental consent for 4 years, 49.3% (95% CI 44.6% to 54.1%) of women and 59.3% (95% CI 54.5% to 64.0%) of men had a test every year. Among students registered for 2 or more years, those with a previous positive chlamydia test were less likely to have a subsequent test (female adjusted OR 0.77, 95% CI 0.67 to 0.88 and male adjusted OR 0.84, 95% CI 0.69 to 1.02). Chlamydia positivity increased over time.
Conclusions High levels of uptake can be achieved in school-based chlamydia screening programmes, but repeated yearly screening is difficult to sustain over time.
- chlamydia infections
- STD surveillance
- epidemiology (clinical)
Correction notice This article has been corrected since it was published online first. The section ‘Methods’ has been updated to read ‘Statistical analysis’.
Competing interests In 2010, NL received fees from GlaxoSmithKline to attend a meeting about chlamydia vaccines.
Ethics approval Ethics approval was provided by Louisiana State University Health Sciences Center Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.