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Epidemiology oral session 1: Chlamydia
O1-S01.03 High yield in reinfections during a chlamydia screening programme when automatically sending testkits after 6 months to previously infected
  1. H M Götz1,
  2. C J P A Hoebe2,
  3. J E A M van Bergen3,
  4. E E H G Brouwers2,
  5. E L M Op de Coul4,
  6. J S A Fennema5,
  7. R H Koekenbier5,
  8. L L Pars3,
  9. S M van Ravesteijn1,
  10. I V F van den Broek4
  1. 1Public Health Service, Rotterdam, Rijnmond, Netherlands
  2. 2Public Health Service, Geleen, South Limburg, Netherlands
  3. 3STI AIDS Netherlands, Amsterdam, Netherlands
  4. 4Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, Netherlands
  5. 5Public Health Service Amsterdam, Amsterdam, Netherlands


Background Reinfections remain challenging in the control of Chlamydia trachomatis (Ct). In a systematic internet-based Ct Screening programme (CSI) in the Netherlands, all Ct-positive participants automatically received a test kit after 6 months to facilitate discovery of reinfections. Determinants for reinfection for two screening rounds, treatment and partner notification are discussed.

Methods CSI-home-based testkits can be requested online after register based postal invitation. Infected participants get a referral letter for their health provider to get treatment for themselves and their current partner; expartners can be alerted by the participant and request a test kit via the website. Participants fill in a questionnaire on sexual behaviour voluntarily. Ct-positives answer questions about treatment and partner notification 10 days after checking their results. Infected participants who do not check their result online receive it by postal letter. After 6 months retest kits are automatically sent to previously infected participants.

Results Overall, 3185 participants (4.1%) tested positive; 7% of Ct-positives did not check their result online and received a postal letter. The majority (86%) of Ct-positive participants who answered the treatment questionnaire (response 43%) was treated within 2 weeks after checking their result online; 80% of those with a current relationship reported their partner had also been treated and 16% of those with past relationships notified ex-partners via the website. One third of the ex-partners participated, 28% of whom were Ct-positive. After 6 months, 3055 participants received a retest kit and 66% responded. The reinfection rate was 8.8%. Results of the questionnaire revealed 75% of retest-positives had been treated for the initial infection and 70% had had their partner treated, while these proportions were 87% and 80% among retest-negatives. At higher risk for reinfections were young people (<20 years 17%), specific ethnic minorities (Netherlands Antillean 16%, Turkish 17%, sub-Sahara African 18%), persons living in Rotterdam (11 vs 8% Amsterdam 4% Limburg), and in high-risk areas (14%).

Conclusions The uptake of retesting was successful counting two third with automatically sent testkits 6 months after screening. Reinfection rates were high, especially among known risk-groups. Questionnaire results show that follow-up of (partner) treatment after Chlamydia infections could be improved.

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