PT  - JOURNAL ARTICLE
AU  - Gwenda Hughes
AU  - Tim Williams
AU  - Ian Simms
AU  - Catherine Mercer
AU  - Kevin Fenton
AU  - Jackie Cassell
TI  - Use of a primary care database to determine trends in genital chlamydia testing, diagnostic episodes and management in UK general practice, 1990–2004
AID  - 10.1136/sti.2006.022673
DP  - 2007 Jul 01
TA  - Sexually Transmitted Infections
PG  - 310--313
VI  - 83
IP  - 4
4099  - http://sti.bmj.com/content/83/4/310.short
4100  - http://sti.bmj.com/content/83/4/310.full
SO  - Sex Transm Infect2007 Jul 01; 83
AB  - Objective: To determine the extent of testing, diagnostic episodes and management of genital Chlamydia trachomatis (CT) infection in UK primary care using a large primary care database. Methods: The incidence of CT tests, diagnostic episodes, treatments and referrals was measured for all adult patients in the General Practice Research Database between 1990 and 2004. Results: Rates of CT testing in those aged 12–64 years in 2004 increased to 1439/100 000 patient years (py) in women but only 74/100 000 py in men. Testing rates were highest among 20–24-year-old women (5.5% tested in 2004), followed by 25–34-year-old women (3.7% tested in 2004). 0.5% of registered 16–24-year-old women were diagnosed as having CT infection in 2004. Three-quarters of patients with a recorded diagnosis of CT had had an appropriate prescription issued in 2004, a proportion that increased from 1990 along with a decrease in referrals to genitourinary medicine. In 2004, general practitioners treated 25.0% of all recorded diagnoses of CT in women and 5.1% of those in men. Conclusions: Testing for and diagnostic episodes of CT in primary care have increased since 1990. Testing continues disproportionately to target women aged >24 years. Extremely low rates of testing in men, together with high positivity, demonstrate a missed opportunity for diagnosis of CT and contact tracing in general practice.