Background Starting July 2013, self-taken extra-genital swabs were offered routinely to all patients attending the department.
Aim To assess detection of extra-genital infection since introduction of self-taken swabs.
Methods We compared patients diagnosed with Chlamydia and Gonorrhoea in the 6-month period before (February–July 2012) and after (February–July 2014) the introduction of self-taken extra-genital swabs. The rate of self-swabbing was determined in separate consecutive groups of 100 patients who had extra-genital swabs in the same periods.
Results There were 408 (98 Gonorrhoea, 310 Chlamydia) detected infections in the 2012 period and 404 (121 Gonorrhoea, 283 Chlamydia) in 2014. Between 2012 and 2014, the rate of detected extra-genital Chlamydia/Gonorrhoea infections increased 4-fold from 18/408, 4.4% to 77/404 19% (P < 0.0001). The rise was seen in both pharyngeal (10/408, 2.45% vs 48/404, 11.8% P < 0.0001) and rectal infections (8/408, 2% vs 40/404, 9.9%, P < 0.0001). Significant rises were seen in MSM in rectal (5/408, 1.2% vs 28/404, 6.9% P < 0.0001) and pharyngeal infection (10/408, 2.5% vs 21/404, 5.2%, P = 0.02) and for women in rectal (3/408, 0.7% vs 12/404, 3% P < 0.02) and pharyngeal infection (0/408, 0% vs 20/404, 5%, P < 0.0001). In these patients, rates of extra-genital self-swabbing rose from 0% (0/24) to 58.5% (141/241), P < 0.0001. In separate samples of consecutive un-infected patients having extra-genital swabs, self-swabbing rose from 0% (0/100) to 90% (90/100) P < 0.0001.
Conclusion The introduction of routine self -taken extra-genital swabs has led to a large rise in detected extra-genital Chlamydia and/or Gonorrhoea infection, especially for MSM and women. The rise in rates of extra-genital self-swabbing shows that this is acceptable and effective.
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