Role of the general practitioner in testing for genital Chlamydia trachomatis infection: an analysis of enhanced surveillance data

Sexual Health ◽  
2009 ◽  
Vol 6 (3) ◽  
pp. 208 ◽  
Author(s):  
Kelly Shaw ◽  
Nicola Stephens ◽  
David Coleman ◽  
Maree O'Sullivan
Keyword(s):  
General Practice ◽  
General Practitioner ◽  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Critical Role ◽  
Surveillance Data ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Clinical Activity

Background: To examine the relationship between genital chlamydia testing by healthcare providers and patient demographic characteristics in Tasmania, Australia, from 2001 to 2007. Methods: Analysis of enhanced surveillance data for genital Chlamydia trachomatis infections notified to the Tasmanian Communicable Diseases Prevention Unit between 1 January 2001 and 31 December 2007. Results: General practitioners identify most cases of genital chlamydia infection, irrespective of patient age, gender, indigenous status or urban status. Tests that are performed for screening purposes identify the largest number of cases in females, particularly in very young females. In males, tests performed due to the presence of clinical symptoms identify the majority of cases. However, tests performed for the purposes of contact tracing also identify a substantial burden of genital chlamydia infection, particularly in males. Conclusions: The present study demonstrates the critical role the general practitioner has in the identification of genital chlamydia infection. Opportunistic screening for genital chlamydia, including in the context of contact tracing, is an essential clinical activity that results in the identification of substantial numbers of cases of infection. Policy makers and public health practitioners should support general practice screening initiatives and remove the barriers to genital chlamydia screening in general practice.

Attitudes to chlamydia screening in general practice among Australian university students: a pilot study

Sexual Health ◽  
2008 ◽  
Vol 5 (4) ◽  
pp. 359 ◽  
Author(s):  
Bernadette Zakher ◽  
Melissa Kang
Keyword(s):  
At Risk ◽  
General Practice ◽  
Pilot Study ◽  
Young People ◽  
University Students ◽  
Risk Group ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Sexually Active ◽  
Sexually Transmissible Infections

Background: Chlamydia screening of sexually active young people in general practice is key to the Australian National Sexually Transmissible Infections Strategy 2005–2008. Overseas research indicates that young people have positive attitudes towards opportunistic screening by a general practitioner (GP). This pilot study aims to investigate the attitudes of Australian university students towards chlamydia screening in primary care. Methods: Students (16–25 years) attending a class in one of three faculties at the University of Sydney participated by completing a questionnaire, which collected information about demographics, sexual history, chlamydia knowledge, attitudes towards and preferences for chlamydia screening. Results: One hundred and eighty-five students (78% female) returned questionnaires (participation rate 92%). Arts students were younger, more likely to be sexually active and to report having little or no knowledge of chlamydia. Males in the study were less likely to have had sex as a group compared to the group of females in the sample. Science students were also less likely to have had sex compared to their counterparts in other faculties. Seventy-six percent of students were comfortable with opportunistic testing for chlamydia by their GP. Reasons for not being comfortable included ‘don’t think I’m at risk’ (65%) and ‘not comfortable discussing sexual matters with my GP’ (38%). Although comfortable with GP-based testing, the likelihood of being tested in the upcoming year for most students was low, as was personal concern about chlamydia infection. Conclusions: Findings suggest that the most at risk group for chlamydia infection is not well educated about their risk of infection. The limited numbers of tests among sexually active individuals in this sample indicate that health practitioners are not screening this high-risk group for chlamydia infection.

Men's attitudes towards chlamydia screening: a narrative review

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 120 ◽  
Author(s):  
Myles Balfe ◽  
Ruairi Brugha ◽  
Emer O'Connell ◽  
Deirdre Vaughan ◽  
Diarmuid O'Donovan
Keyword(s):  
General Practice ◽  
Chlamydia Trachomatis ◽  
Narrative Review ◽  
Future Research ◽  
Chlamydia Screening ◽  
Perceived Vulnerability ◽  
Screening Services ◽  
Urine Testing ◽  
Sexually Transmissible Infection ◽  
Transmissible Infection

Objectives Chlamydia trachomatis is a sexually transmissible infection (STI) that affects significant numbers of men. Research on men’s perspectives on chlamydia screening (or testing) has been limited. We conducted a narrative review to examine: (1) what factors encourage or discourage men from attending health services for chlamydia screening, and/or from accepting screening once it has been offered to them, and (2) where men want chlamydia screening services to be located. Methods: A narrative review of the recent peer-reviewed literature (published between 1999 and 2009) on men’s attitudes towards chlamydia screening. To be included, articles had to explore men’s perspectives on screening (which could be ascertained through quantitative or qualitative studies, or from relevant discussion papers or reviews). Results: Forty-eight articles were included in all. Men’s attitudes towards chlamydia screening are influenced by their knowledge about the infection, their perceived vulnerability to the infection, the degree of embarrassment and shame that they associate with screening and the stigma that they associate with screening. Men prefer to be offered urine testing for chlamydia. Men want to be offered screening by non-judgemental professionals. Men’s attitudes towards screening for chlamydia in general practice, genito-urinary medicine clinics, home and outreach settings are also explored in this review. Conclusions: Several factors influence men’s attitudes towards screening. Two central themes underlie and influence many of these factors: men’s needs to make positive impressions on others, and men’s identification with particular ideals of masculinity. The review concludes with suggestions for future research on this topic.

scholarly journals Denominators count: supplementing surveillance data for genital Chlamydia trachomatis infection with testing data, Norway, 2007 to 2013

2015 ◽  
Vol 20 (36) ◽  
Author(s):  
Hilde Kløvstad ◽  
Preben Aavitsland
Keyword(s):  
Chlamydia Trachomatis ◽  
Age Distribution ◽  
Age Groups ◽  
Surveillance Data ◽  
Chlamydia Infection ◽  
Age Group ◽  
Aggregated Data ◽  
Chlamydia Trachomatis Infection ◽  
Testing Data ◽  
Testing Coverage

As genital Chlamydia trachomatis (chlamydia) infection is often asymptomatic, surveillance of diagnosed cases is heavily influenced by the rate and distribution of testing. In 2007, we started supplementing case-based surveillance data from the Norwegian Surveillance System for Communicable Diseases (MSIS) with aggregated data on age group and sex of individuals tested. In this report, annual testing rates, diagnosis rates and proportion positive for chlamydia in Norway between 1990 and 2013 are presented. From 2007, rates are also stratified by age group and sex. The annual testing rate for chlamydia culminated in the early 1990s, with 8,035 tested per 100,000 population in 1991. It then declined to 5,312 per 100,000 in 2000 after which it remained relatively stable. Between 1990 and 2013 the annual rate of diagnosed cases increased 1.5 times from ca 300 to ca 450 per 100,000 population. The proportion of positive among the tested rose twofold from ca 4% in the 1990s to 8% in 2013. Data from 2007 to 2013 indicate that more women than men were tested (ratio: 2.56; 95% confidence interval (CI): 2.56–2.58) and diagnosed (1.54; 95% CI: 1.52–1.56). Among tested individuals above 14 years-old, the proportion positive was higher in men than women for all age groups. Too many tests are performed in women aged 30 years and older, where 49 of 50 tests are negative. Testing coverage is low (15%) among 15 to 24 year-old males. Information on sex and age-distribution among the tested helps to interpret surveillance data and provides indications on how to improve targeting of testing for chlamydia. Regular prevalence surveys may address remaining limitations of surveillance.

scholarly journals POINT OF CARE RAPID DIAGNOSTIC SCREENING FOR CHLAMYDIA TRACHOMATIS AMONG SEXUALLY ACTIVE ASYMPTOMATIC FEMALES IN OKADA, SOUTH-SOUTH NIGERIA

2021 ◽  
Vol 4 (1) ◽  
pp. 4-7
Author(s):  
Obhioze Augustine Akpoka ◽  
E. J. Okafor-Elenwo ◽  
C. C. Nwadukwe ◽  
M. U. Okwu
Keyword(s):  
Chlamydia Trachomatis ◽  
Point Of Care ◽  
Age Groups ◽  
Previous History ◽  
Public Health Intervention ◽  
Rapid Test ◽  
University Teaching ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Sexually Active

Introduction: Chlamydia is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. It can be transmitted or acquired even without ejaculation. It can also be transmitted perinatally from an untreated mother to her baby during childbirth, resulting in ophthalmia neonatorum or pneumonia in some exposed infants. Objective: The objective of this study was to screen for and determine the prevalence of Chlamydia trachomatis in asymptomatic sexually active women aged 16-33 years with the aid of a point of care rapid test kits within a resource-limited setting. Methods: In this study endocervical swab of a total of 170 female subjects between the ages of 16 to 33 were screened for Chlamydia trachomatis with two types of rapid test kits (Diaspot and Abon Rapid test kits for chlamydia). The subjects consisted of 140 study subjects and 30 control subjects attending the gynecological unit in Igbinedion University Teaching Hospital (IUTH) for other reasons, all subjects were random, sexually active, asymptomatic females and residents in Okada and its environs. Results: A total of 11 subjects tested positive to chlamydia (7.85 %). The samples that tested positive for Chlamydia were from patients that were unmarried and students. The age groups with the highest prevalence were 22-28 (5.71 %) and 16-21 (2 %). 23.63 % have had a previous history of STD and 26.47 % had awareness of chlamydia infection. The ages group (22 - 27) had the highest level of awareness. The prevalence of Chlamydia trachomatis was consistent with their sexual lifestyles. Conclusion: Chlamydia screening should be a continuous public health intervention and screening programmes should ensure regular chlamydia screening for a high proportion of the target population. The methods for monitoring and ways to ensure standards are met should be adopted.

Screening for genital chlamydia infection: DNA amplification techniques should be the test of choice

2003 ◽  
Vol 14 (11) ◽  
pp. 723-726 ◽  
Author(s):  
V Harindra ◽  
G Underhill ◽  
J M Tobin
Keyword(s):  
Chlamydia Trachomatis ◽  
False Negative ◽  
Dna Amplification ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Molecular Testing ◽  
Chain Reaction ◽  
Men And Women ◽  
Genitourinary Medicine ◽  
The Uk

Our objective was to compare the sensitivities for the detection of Chlamydia trachomatis, of the ligase chain reaction (LCR) on first voided urine (FVU) specimens and enzyme immunoassay (EIA) on pooled endocervical/endourethral swabs from women and endourethral swabs from men. Men and women taking part in the UK chlamydia screening pilot were tested for chlamydia using LCR on a FVU. Patients attending genitourinary medicine clinics also had cervical and/or urethral swabs taken for chlamydia testing by EIA. In women, EIA on pooled swabs detected 575 of the 785 chlamydia positives and in men, EIA detected 209 of 351 positives. The sensitivity of EIA was 73% and 60% in women and men respectively. By using the EIA test, therefore, 27-40% of patients infected with chlamydia will be given a false negative result. We propose that it is unethical to use non-molecular testing in the future.

An audit of contact tracing for cases of chlamydia in the Australian Capital Territory

Sexual Health ◽  
2005 ◽  
Vol 2 (4) ◽  
pp. 255 ◽  
Author(s):  
Danelle O. England ◽  
Marian J. Currie ◽  
Francis J Bowden
Keyword(s):  
Health Centre ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
Australian Capital Territory ◽  
Background Rate ◽  
Sexually Transmitted ◽  
Australian Capital ◽  
Sexual Contacts ◽  
Index Cases

Background: Contact tracing is one of the central pillars of the management of sexually transmitted infections. The aims of this audit were to determine the yield of chlamydia infection from contact tracing the sexual partners of individuals diagnosed with chlamydia and to evaluate and compare the effectiveness of contact tracing undertaken at the Communicable Diseases Control Section (CDCS) of Australian Capital Territory (ACT) Health and the Canberra Sexual Health Centre (the clinic). Methods: A retrospective review of the notification records and contact-tracing documentation was undertaken at CDCS and the clinic from 1 September 2002 to 30 September 2003 (13 months). Results: The background rate of chlamydia in those tested in the ACT community is 3–5%. During the study period, 512 cases of chlamydia were notified to CDCS. Of these, 351 were referred for contact tracing, 293 by CDCS and 98 by the clinic. Of the 437 nominated sexual contacts (average of 1.12 per index case), 272 (62.2%) were contacted, 125 (28.6%) were tested and 51 (11.7%; 95% CI 8.8–15.1) tested positive for chlamydia (15.5%; 95% CI 11.5–20.6% in sexual contacts of CDCS index cases and 7.8%; 95% CI 4.8–12.5% in those of the clinic patients). Contact tracing through the CDCS reached significantly more nominated sexual contacts (78.4% v. 41.7%; P = 0.001) and significantly more of the nominated sexual contacts of index cases reported to CDCS were described as tested (34.7% v. 20.8%; P = 0.01). The average time taken to identify each chlamydia-positive sexual contact was 6.8 hours. Conclusions: Contact tracing more than doubled the case finding effectiveness of chlamydia screening, but was time consuming. These results suggest that provider-initiated contact tracing has clinical and public health value, but that the cost-effectiveness of this approach to chlamydia control should be further evaluated.

scholarly journals Trends in genital chlamydia infection in the Mid-West of Ireland, 2001-2006

2007 ◽  
Vol 12 (10) ◽  
pp. 13-14 ◽  
Author(s):  
D Whyte ◽  
J Powell ◽  
M Horgan ◽  
N O’Connell ◽  
R FitzGerald ◽  
...  
Keyword(s):  
General Practitioners ◽  
Transmitted Disease ◽  
Contact Tracing ◽  
Chlamydia Infection ◽  
Chlamydia Screening ◽  
National Surveillance ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
West Of Ireland

Genital Chlamydia trachomatis (GCT) infection is the most common bacterial sexually transmitted infection (STI) in Ireland. A retrospective analysis of 2,087 laboratory-confirmed GCT patient episodes from 2001 to 2006 in the Mid-West of Ireland was undertaken in conjunction with statutorily notifiable data that were reported by the Sexually Transmitted Disease/Genito-Urinary Medicine (STD/GUM) services in the region and used in national surveillance. Data were analysed by year, source, sex and age. The annual incidence of GCT in the Mid-West is increasing. A substantial proportion of GCT infections were diagnosed in the non-STD/GUM setting. The issue of sexually active young people seeking STI screening is a sensitive one, and delays increase the potential for transmission and the possibility of long-term complications when the disease is not treated. Based on this sample, national surveillance would significantly underestimate the burden of disease in Ireland, due to under-reporting. This would have implications for any national chlamydia screening programme. Among those who sought testing, women aged 15 to 19 years are five times more likely to be found positive than men in the same age group. Of those diagnosed in the non-STD/GUM setting, 83% were women. General practitioners and clinicians might consider targeting those aged 15 to 29 years for opportunistic screening and sexual health advice. Contact tracing and follow-up in the non-STD/GUM setting, as well as access for general practitioners to ongoing education on STIs are challenges to be addressed.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

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