Which women should be tested for <i>Chlamydia trachomatis</i>?

Macmillan, Susan; McKenzie, Hamish; Flett, Gillian; Templeton, Allan

doi:10.1111/j.1471-0528.2000.tb11105.x

Cited by 33 publications

(16 citation statements)

References 32 publications

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“…Macmillian et al reported similar prevalence and decreasing trend with age, where infection levels only dramatically decreased in women aged 30 and above. 9 This suggests that the upper age limit for screening in this study, as proposed by the chief medical officer's expert advisory group on C trachomatis 1 and thus likely to be used in a national programme, needs to be reviewed. Bias due to the self selection of cases will influence the prevalence seen; however, uptake of testing was universally high among all age groups and healthcare settings.…”

Section: Discussionmentioning

confidence: 99%

Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases

Pimenta¹,

Catchpole

Rogers³

et al. 2003

Sexually Transmitted Infections

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Objectives: To determine the prevalence and treatment outcomes among young women screened opportunistically for genital Chlamydia trachomatis and to evaluate the impact of screening in those participating. Design: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples, tested by ligase chain reaction (LCR). In-depth interviews were used for programme evaluation. Setting: Screening was offered in two health authorities at general practice, family planning, genitourinary medicine (GUM), adolescent sexual health, termination of pregnancy clinics and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics). Main participants: Sexually active women (16-24 years) attending for any reason. Main outcome measures: Screening data: prevalence of infection by age and healthcare setting; proportion of positive patients attending for treatment. Evaluation data: participants' attitudes and views towards screening and follow up. Results: In total, 16 930 women (16-24 years) were screened. Prevalence was higher in younger women (16-20) than those aged 21-24 years and was highly variable at different healthcare settings (range 3.4%-17.6%). Prevalence was approximately 9% in general practice. The role of the project health advisers in managing results and coordinating treatment of positive individuals was essential; the vast majority of all positives were known to be treated. Women felt that screening was beneficial. Improving awareness and education about sexually transmitted infections is required to alleviate negative reactions associated with testing positive for infection. Conclusions: Prevalence of infection outside GUM clinics is substantial and opportunistic screening using urine samples is an acceptable method of reaching individuals with infection who do not normally present at specialist clinics.T his paper presents data from a large scale pilot of opportunistic screening for genital Chlamydia trachomatis infection at a range of healthcare settings including primary care. Offering opportunistic screening at healthcare settings outside genitourinary medicine (GUM) clinics is likely to detect many infected individuals who may not consider themselves at risk of infection, or who are asymptomatic and so would not normally be diagnosed. The main aim of the pilot, which was undertaken in response to the recommendations of the chief medical officer's expert advisory group on Chlamydia trachomatis, 1 was to assess the feasibility and acceptability of screening in healthcare settings outside GUM clinics. In addition, the study has generated accurate estimates of prevalence in healthcare settings outside GUM clinics, which can be used to inform decision making on the cost effectiveness of screening and which settings should be utilised in a national screening programme. In this paper, we present results on the prevalence of infection, treatment outcomes, and the impact of screening on young people taking part in the programme. METHODSA full description of th...

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Section: Discussionmentioning

confidence: 99%

Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases

Pimenta¹,

Catchpole

Rogers³

et al. 2003

Sexually Transmitted Infections

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“…Previous studies have reported a prevalence of between 1% and 29% depending on the population studied, the selection criteria and diagnostic tests used, with the highest rates found in under 25-year-olds. [5][6][7][8][9][10][11][12] Studies in other countries have shown that screening and treatment for C. trachomatis significantly reduces the prevalence of the infection and PID in women. [13][14][15] In 1998 the Chief Medical Officer (CMO) published the report of the CMO's Expert Advisory Group on Chlamydia trachomatis 5 which was set up to consider the practical implications of screening.…”

Section: Introductionmentioning

confidence: 99%

Who has chlamydia? The prevalence of genital tract <I>Chlamydia trachomatis</I> within Portsmouth and South East Hampshire, UK

Underhill¹,

Hewitt²,

McLean³

et al. 2003

j fam plann reprod health care

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“…Macmillan et al found similar chlamydia prevalence rates in women attending for miscarriage (4.0%) and for TOP (5.7%), while Shankar et al described much lower rates for women presenting to an early pregnancy unit (1.96%). 6,10 Obviously further research is needed to confirm prevalence numbers for this group in our population.…”

Section: Discussionmentioning

confidence: 92%

Chlamydia screening and treatment in patients undergoing evacuation of retained products of conception or vaginal termination of pregnancy: an audit of the Royal College of Obstetricians and Gynaecologists' Guidelines in practice

Zenner

2007

j fam plann reprod health care

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Objective To assess compliance with the Royal College of Obstetricians and Gynaecologists Guidelines regarding screening for and treatment of Chlamydia trachomatis before vaginal termination of pregnancy (VTOP) and surgical evacuation of retained products of conception (ERPC).Methods Case notes of women undergoing VTOP and ERPC in the authors' department were examined for evidence of the presence of C. trachomatis infection and identification of chlamydia risk factors, and for evidence of curative treatment for women with confirmed infection or prophylactic treatment for women at risk. Good evidence demonstrates that surgical termination of pregnancy in the presence of underlying lower genital tract infection with Chlamydia trachomatis increases the risk of post-abortion pelvic infection leading to complications such as tubal infertility, ectopic pregnancy, chronic pelvic pain and pelvic inflammatory disease. The risk decreases significantly if either prophylactic antibiotics are given, or confirmed infections are treated, before or at the time of vaginal termination of pregnancy (VTOP). 3,4 The RCOG Guidelines also advise screening for C. trachomatis before surgical evacuation of retained products of conception (ERPC) for missed or incomplete miscarriage in women at risk for chlamydia infection, especially women aged under 25 years. However, in this case universal prophylactic administration of antibiotics is not supported by published evidence. 5 One factor that may account for the different advice may be the assumed lower risk profile in women with miscarriage in comparison to women requesting termination, although data regarding this assumption are scarce. Correspondence to: Dr Robin Crawford, Department of Gynaecology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK. E-mail: robin.crawford@addenbrookes.nhs.uk assessment proforma. In the ERPC group (n = 30) there were weaknesses in the identification and treatment of patients at risk. Results Chlamydia screening and treatment in patients undergoing ConclusionsWe conclude that the use of a proforma helps to achieve effective screening. Adequate risk assessment of women undergoing ERPC seems to be difficult to achieve and so universal administration of prophylactic antibiotics might be a safe and efficient option until the National Chlamydia Screening Programme is established in our area.

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Which women should be tested for Chlamydia trachomatis?

Cited by 33 publications

References 32 publications

Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases

Opportunistic screening for genital chlamydial infection. II: Prevalence among healthcare attenders, outcome, and evaluation of positive cases

Who has chlamydia? The prevalence of genital tract <I>Chlamydia trachomatis</I> within Portsmouth and South East Hampshire, UK

Chlamydia screening and treatment in patients undergoing evacuation of retained products of conception or vaginal termination of pregnancy: an audit of the Royal College of Obstetricians and Gynaecologists' Guidelines in practice

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