UK National Audit of Chlamydial Infection Management in Sexual Health Clinics. Case notes audit: demography, diagnosis and treatment

Abstract

The case notes of cases of genital chlamydial infection were audited against the UK National Guideline. This was the first web-based and the largest national audit to date, with 193 clinics in all UK Regions contributing data. About half of all cases had no symptoms, with about one-third attending for routine or asymptomatic screens; suggesting significant provision of screening by clinics that might be managed differently to reduce workload. Nucleic acid amplification tests (NAATs) are now well established for chlamydial detection in UK clinics, with 93% of cases having genital NAATs. Azithromycin is now more commonly used than doxycycline (54% vs. 37%). Of 26 pregnant women, 20 were treated with azithromycin, suggesting that most prescribers treating pregnant women consider that erythromycin is not an adequate alternative to azithromycin. Most women had NAATs obtained from sites recommended by the Guideline, with 93% of women who had genital NAATs having these from the cervix or vulvovaginal area.

Effectiveness and cost-effectiveness of traditional and new partner notification technologies for curable sexually transmitted infections: observational study, systematic reviews and mathematical modelling

“…The British Association for Sexual Health and HIV carried out a national audit of case note documentation of chlamydial infection management in UK genitourinary medicine clinics in 2007. [66][67][68] These data allow auditable outcomes to be analysed and sources of variation to be examined. Biological outcomes, such as the rate of repeated detection, cannot be measured because repeat testing after treatment of positive cases is not included in treatment guidelines.…”

National audit of asymptomatic screening in UK genitourinary medicine clinics: case-notes audit

“…9 However, there is considerable inter-regional variation, with up to 35% and 26% difference in testing rates for asymptomatic women and heterosexual men, respectively, contrasting with much more consistent testing rates for MSM. Although not directly comparable, the rates of HIV screening in this audit suggest improvement compared with the rates of testing in the BASHH 2007 audit of 5032 people with chlamydial infection: 10 83% versus 67%, 94% versus 73% and 81% versus 65% for heterosexual men, MSM and women, respectively.…”

Is everyone treated equally? Management of genital Chlamydia trachomatis infection in New Zealand

“…18 Men in the study were also more likely to be a contact of a chlamydia case. Others have reported men as being more likely to receive immediate treatment, 19,20 and have suggested clinical features or the use of on-site microscopy as important influences. None of the settings involved in our study use on-site microscopy yet, encouragingly, the overall median time-to-treatment of five days is comparable to that previously reported from specialist genitourinary clinic audits.…”