Who Is Best to Test? A Systematic Review of Chlamydia Infections in Switzerland

Abstract

In many countries, community pharmacies provide sexual-health-related services to limit the spread of sexually transmitted infections (STIs), including chlamydia testing. To identify suitable target groups for pharmacy-based chlamydia testing in Switzerland, we aimed to assess chlamydia prevalence, identify risk groups, and delineate screening strategies. We conducted a systematic literature search up to December 2019 in PubMed, EMBASE, and Web of Science, according to the PRISMA guidelines, using as keywords “chlamydia”, “screening”, and “Switzerland”. Two researchers screened the title, abstract, and full-text article and assessed the methodological quality. The literature search generated 108 hits, and nine studies were included. Chlamydia prevalence ranged between 0.8 and 12.8%. Most frequently affected were undocumented women undergoing voluntary termination of pregnancy (12.8%, 95% CI: 8.4–18.9), HIV-positive men who have sex with men (10.9%, 95% CI: 9.2–17.6), and adult offenders (6.5%, 95% CI: 3.2–9.0). Systematic screening was suggested for the first two risk groups and women suffering a miscarriage. To conclude, chlamydia infections are prevalent in Switzerland, but the identified risk groups are difficult to reach for a pharmacy-based testing service. More studies are needed to identify suitable target groups, including customers seeking sexual health services, particularly emergency contraception users who already receive counselling for STIs at community pharmacies.

High prevalence of Chlamydia trachomatis infection among women attending STD and gynecology clinics in Jiangsu province, China

“…First, extramarital sexual behaviors and multiple sexual partners were more likely to occur. Second, because of better medical resources and higher incomes, women with symptoms or risks of CT infection in this region were likely to be well educated and mobilized enough to get CT tests [24,25] …”

“…Second, because of better medical resources and higher incomes, women with symptoms or risks of CT infection in this region were likely to be well educated and mobilized enough to get CT tests. [24,25] Through this study, we obtained the prevalence of CT infection among women attending STD and gynecology clinics in Jiangsu province and possible risk factors, which is very important for future chlamydia control. However, several limitations of this study should be noted.…”

Sexually Transmitted Diseases: Diagnosis and Control

“…Future approaches to identify target risk groups might include chlamydia prevalence testing among emergency contraception users attending community pharmacies. Furthermore, to reinforce the pharmacist's new role as a gateway to health care, further pharmacybased services might be developed to target individuals at particular risk for chlamydia infections in Switzerland, such as individuals with multiple infections including HIV or hepatitis C [2].…”