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Variation in partner notification outcomes for chlamydia in UK genitourinary medicine clinics: multilevel study
  1. Sereina A Herzog1,
  2. Hugo McClean2,
  3. Chris A Carne3,
  4. Nicola Low1
  1. 1Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
  2. 2Sexual and Reproductive Healthcare Partnership, City Health Care Partnership, Hull, UK
  3. 3Department of Genitourinary Medicine, Addenbrookes Hospital, Cambridge, UK
  1. Correspondence to Nicola Low, Division of Clinical Epidemiology & Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern 3012, Switzerland; low{at}


Objectives To compare different ways of measuring partner notification (PN) outcomes with published audit standards, examine variability between clinics and examine factors contributing to variation in PN outcomes in genitourinary medicine (GUM) clinics in the UK.

Methods Reanalysis of the 2007 BASHH national chlamydia audit. The primary outcome was the number of partners per index case tested for chlamydia, as verified by a healthcare worker or, if missing, reported by the patient. Control charts were used to examine variation between clinics considering missing values as zero or excluding missing values. Hierarchical logistic regression was used to investigate factors contributing to variation in outcomes.

Results Data from 4616 individuals in 169 genitourinary medicine clinics were analysed. There was no information about the primary outcome in 41% of records. The mean number of partners tested for chlamydia ranged from 0 to 1.5 per index case per clinic. The median across all clinics was 0.47 when missing values were assumed to be zero and 0.92 per index case when missing values were excluded. Men who have sex with men were less likely than heterosexual men and patients with symptoms (4-week look-back period) were less likely than asymptomatic patients (6-month look-back) to report having one or more partners tested for chlamydia. There was no association between the primary outcome and the type of the health professional giving the PN advice.

Conclusions The completeness of PN outcomes recorded in clinical notes needs to improve. Further research is needed to identify auditable measures that are associated with successful PN that prevents repeated chlamydia in index cases.

  • Chlamydia infections
  • contact tracing
  • quality of healthcare
  • clinical audit
  • outcome assessment (healthcare)
  • audit
  • Chlamydia trachomatis
  • contact tracing
  • health advice
  • health services research

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  • Funding SAH is funded by a Swiss National Science Foundation ProDoc award (PDFMP3_124952), Swiss National Science Foundation, Switzerland. This work was supported by the NIHR Health Technology Assessment programme [project number 07/42/02]. Part of this study will be published in the Health Technology Assessment journal series. Visit the HTA programme website for more details ( The views and opinions in this article are those of the authors and do not necessarily reflect those of the Department of Health.

  • Correction notice This article has been corrected since it was published Online First. The final sentence of the abstract has been amended to read: Further research is needed to identify auditable measures that are associated with successful PN that prevents repeated chlamydia in index cases.

  • Competing interests HM and CAC are members of the National Audit Group.

  • Provenance and peer review Not commissioned; externally peer reviewed.