Genital chlamydia in southern New South Wales: An ecological analysis of testing and notification patterns 2004–2008

Reynolds, Roderick; Oakman, Tracey

doi:10.1111/j.1440-1584.2010.01134.x

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…A statistician, located at a site away from the clusters, generated the randomisation sequence using a computer-generated minimisation algorithm. The algorithm aimed to achieve balance for three pre-specified variables: i) estimated chlamydia prevalence (<3% vs. ≥3%, based on an earlier study); 11 ii) chlamydia testing rate (<6% vs. ≥6% based on data from rural primary care clinics in 2008); 12 and iii) number of 16 to 29 year olds in the town (<2000 vs. ≥2000, the 75th percentile of population size in eligible postcodes). The statistician ran the randomisation algorithm after the baseline estimation of chlamydia prevalence in each cluster and informed research staff of the allocation who in turn notified clinics.…”

Section: Randomisation and Maskingmentioning

confidence: 99%

Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial

et al. 2018

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Research in context Evidence before this study A systematic review of chlamydia screening interventions identified six RCTs published up to the 14 th February 2016, four of which investigated the effect on the incidence of PID of a single offer of a chlamydia screening test and two which investigated the effect of multiple rounds of chlamydia screening on chlamydia prevalence. In a meta-analysis, the incidence of PID was lower in intervention than control groups (risk ratio, RR 0•68; 95%CI 0•49 to 0•94; I 2 =8%). However, methodological limitations of the trials could have resulted in an overestimation of the protective effects of a single chlamydia screening test. A cluster-RCT in women and men in the general population in the Netherlands found no change in chlamydia positivity among those tested after three rounds of screening (RR 0•96, 95% CI 0•84 to 1•09). However, screening uptake was low, with only 16% screened in the first round, falling to 10% in the third round. A cluster RCT of a multifaceted intervention that included syndromic management for sexually transmitted infections (STIs) among young adults in the community and STI screening in female sex workers in Peru found no difference in chlamydia prevalence after four years among young adults but in secondary analyses, found a reduction among female sex workers (adjusted RR 0•72; 95% CI 0•54 to 0•98). None of the trials investigated the impact of multiple rounds of testing on both chlamydia prevalence and the incidence of PID. We searched PubMed from January 1 2016 to February 28 2018 with the terms "chlamydia" and ("randomised controlled trial" or "randomised clinical trial" or "trial" or "randomly") and restricted the search to clinical trials in English only. No further completed trials were identified.

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Section: Randomisation and Maskingmentioning

confidence: 99%

Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial

et al. 2018

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“…General practice is also where the majority of chlamydia diagnoses in Australia are made. 13 Current Australian guidelines for chlamydia screening in general practice recommend annual testing of all sexually active people aged 15-29 and patients with a recent change in partner or reporting inconsistent condom use. 14 A study of Australian general practitioners (GPs) found that chlamydia testing was occurring in 0.32% of patient encounters overall; however, in an age group most relevant to screening (age [15][16][17][18][19][20][21][22][23][24], tests were being performed in 1.32% of encounters.…”

mentioning

confidence: 99%

Testing and screening for chlamydia in general practice: a cross‐sectional analysis

Thomson

Morgan²,

Henderson³

et al. 2014

Australian and New Zealand Journal of Public Health

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Objectives: Chlamydia screening is widely advocated. General practice registrars are an important stage of clinical behaviour development. This study aimed to determine rates of, and factors associated with, registrars' chlamydia testing including asymptomatic screening. Methods:A cross-sectional analysis of data from Registrars Clinical Encounters in Training (ReCEnT), a cohort study of registrars' consultations. Registrars record details of 60 consecutive consultations in each GP-term of training. Outcome factors were chlamydia testing, asymptomatic screening and doctor-initiated screening.Results: Testing occurred in 2.5% of 29,112 consultations (398 registrars) and in 5.8% of patients aged 15-25. Asymptomatic screening comprised 47.5% of chlamydia tests, and 55.6% of screening tests were doctor-initiated. Chlamydia testing was associated with female gender of doctor and patient, younger patient age, and patients new to doctor or practice. Asymptomatic screening was associated with practices where patients incur no fees, and in patients new to doctor or practice. Screening of female patients was more often doctorinitiated.Conclusions: GP registrars screen for chlamydia disproportionately in younger females and new patients.Implications: Our findings highlight potential opportunities to improve uptake of screening for chlamydia, including targeted education and training for registrars, campaigns targeting male patients, and addressing financial barriers to accessing screening services.

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Genital chlamydia in southern New South Wales: An ecological analysis of testing and notification patterns 2004–2008

Cited by 2 publications

References 16 publications

Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial

Population effectiveness of opportunistic chlamydia testing in primary care in Australia: a cluster-randomised controlled trial

Testing and screening for chlamydia in general practice: a cross‐sectional analysis

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