Management of &lt;I&gt;Chlamydia trachomatis&lt;/I&gt; in a women's hospital: A review of current practice

Gleave, Toni; Hopwood, Jenny; Mallinson, H

doi:10.1783/147118901101195399

Cited by 4 publications

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References 2 publications

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“…Costs of infection in the UK are estimated at over £200 million per annum. 11 The prevalence of chlamydia infection in primary care is thought to affect between 2% and 12% of British women. 12 Research and specific pilot studies have looked at different options for screening for chlamydia in general practice and have evaluated the use of different sample-taking methods.…”

Section: Griffiths Et Almentioning

confidence: 99%

“…It is the commonest single cause of infertility in women under the age of 35 years, and is the most frequent cause of epididymitis in young men. 10,11 Early (practices without a single response and those with a below 30% response rate) were sent one identical follow-up questionnaire 3 weeks later. The overall response rate excluded the pilot study although qualitative comments were included in the main analysis.…”

Section: Introductionmentioning

confidence: 99%

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Clinical management of chlamydia in general practice: A survey of reported practice

Griffiths

Cuddigan²

2002

j fam plann reprod health care

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Background. Chlamydia trachomatis is the most common curable sexually transmitted infection (STI) in the UK. Prevalence of the infection in different health IntroductionChlamydia trachomatis is the most frequently occurring sexually transmitted infection (STI) in the UK. 1,2 It causes a spectrum of complications ranging from the simple and asymptomatic to the more complicated and severe and is most common in the younger sexually active population (20-24-year-old men and 16-19-year-old women). 3 In 1999 there were around 57 000 new episodes of the infection in genitourinary medicine (GUM) clinics in the UK, 4 which increased to over 62 500 in 2000. 5,6 In GUM clinics within DPHA, Wales, specifically Carmarthenshire and Pembrokeshire, the prevalence of chlamydia in new GUM attenders is about 10%, which is comparable to UK prevalence rates generally (estimated at between 2% and 29% in different health care settings) 7 and is amongst the highest in Wales. Not only is the absolute number of cases increasing year on year in DPHA but the percentage tested positive is significantly higher (doubled proportion tested positive between 1997 and 1999). 8 It is estimated, however, that only 10% of all chlamydial infections are diagnosed in the GUM setting. 3,9 This means that a high number of infected individuals are either seen and treated in other health care settings or that a large reservoir of undiagnosed infection exists within the general population. Research demonstrates that chlamydia has increasingly been detected outside the GUM setting, however that the number of cases isolated remains relatively low. The problem is exacerbated by the fact that chlamydia is asymptomatic in at least 70% of women and 50% of men which means detection is often limited. 10 Prevalence studies in the UK among women in different health care settings have shown there is a substantial level of asymptomatic infection even among those generally perceived to be at low risk of an STI. 10 If left untreated, chlamydial infection can lead to serious reproductive morbidity. 9 Chlamydia is the causative organism in one-third of cases of pelvic inflammatory disease (PID) which can result in chronic pelvic pain and ectopic pregnancy. It is the commonest single cause of infertility in women under the age of 35 years, and is the most frequent cause of epididymitis in young men. 10 General practitioners (GPs) and practice nurses are in a position, with the input of appropriate resources, to play an important role in the detection of chlamydial infection at an early stage. GPs and practice nurses are in need of, and are in favour of, further needs-based education and training in the identification and management of genital chlamydial infection.

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Section: Griffiths Et Almentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical management of chlamydia in general practice: A survey of reported practice

Griffiths

Cuddigan²

2002

j fam plann reprod health care

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“…3 The potential dangers of not treating asymptomatic cases should not be underestimated as untreated chlamydial infection is the commonest single cause of infertility in women under 35 years, a causative organism in one-third of the cases of pelvic inflammatory disease (PID), and the most common cause of epididymitis in young men. 4,5 The estimated cost of treating chlamydia and its sequelae in the UK is £200 million per year. 6 Chlamydia is an easily treatable condition, and the screening and treating of asymptomatic women reduces the incidence of PID by 56%.…”

Section: Study Participants and Methodsmentioning

confidence: 99%

Implementation of chlamydia screening in a general practice setting: a 6-month pilot study

Harris¹

2005

j fam plann reprod health care

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Objective To determine whether screening for asymptomatic Chlamydia trachomatis infection could be undertaken in the context of a smear clinic or other sexual health consultation in general practice.Methods A prospective, opportunistic, cohort study was undertaken in a general practice setting. The participants were asymptomatic women aged 16-24 years and men aged 16-34 years who were screened for Chlamydia trachomatis by testing endocervical swabs or first-voided urine samples. The main outcome measure was the uptake of the screening offer and the presence or absence of chlamydia infection as indicated by the test result.Results A total of 115 patients (109 women and six men) were offered screening. Eighty-one (70%) patients accepted, with five positive results, giving an overall prevalence of 6.2% (5/81, 95% CI 1-11%). Of those offered screening when having a smear, 8.3% (3/36, 95% CI 0-17%) were positive. ConclusionScreening for chlamydia can be undertaken in the context of existing services offered in general practice (e.g. a smear clinic or consultation) where contraception/sexual health is discussed. Key message pointsG Screening for asymptomatic chlamydia infection can be offered in general practice.G Consultations for contraception or sexual health advice provide an opportunity to offer screening for chlamydia.G Screening for and treating symptomatic chlamydia may help reduce the incidence of, and sequelae from, untreated infection. 109 J Fam Plann Reprod Health Care 2005: 31(2) Methods Study objectives and designA chlamydia screening pilot study was undertaken in a general practice setting to see if it would be feasible to incorporate screening into existing services offered at our practice. A 6-month prospective cohort study was undertaken. Study participants and methodsThe practice is suburban, with five full-time principal general practitioners (GPs) (one female), two full-time practice nurses (PNs) and two part-time health care assistants (HCAs). The total practice population of 9030 is relatively stable, with 516 women aged 16-24 years and 541 men aged 16-34 years. In this study the target populations were as follows: women aged 16-24 years who attended for a smear, intrauterine contraceptive device (IUD) fit, emergency contraception, or who were continuing with, or starting, the oral contraceptive pill; and men aged 16-34 years attending for a new patient check or travel immunisations who were offered screening as part of information and advice on sexual health/safer sex practice.An interactive educational meeting with GPs and PNs was undertaken at the inception of the pilot to discuss chlamydia screening, the type of information a patient might want, the issues likely to be addressed in pretest counselling, and the appropriate technique for taking an endocervical swab. The study was approved by the local research ethics committee.Before starting the pilot study a retrospective search was made for women aged 16-24 years who had attended for a contraceptive consultation (pill check, to sta...

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'Taking the strain' from chlamydia screening

Hopwood¹,

Mallinson²,

Gleave³

2004

j fam plann reprod health care

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Management of <I>Chlamydia trachomatis</I> in a women's hospital: A review of current practice

Cited by 4 publications

References 2 publications

Clinical management of chlamydia in general practice: A survey of reported practice

Clinical management of chlamydia in general practice: A survey of reported practice

Implementation of chlamydia screening in a general practice setting: a 6-month pilot study

'Taking the strain' from chlamydia screening

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