Chlamydia testing in practice - requisitioners and patients.

Abstract

Optimising the diagnostic work-up and treatment of genital chlamydia infection requires knowledge of the sampling patterns of those who order chlamydia tests. We wished to determine which groups of doctors collect specimens for chlamydia testing, and to examine the sex and age distribution of patients tested, and the proportion of positive tests, from general practitioners, gynaecologists in private practice, and youth health services. The study includes 43 465 specimens analysed for genital infection with Chlamydia trachomatis at Vestfold Hospital Trust over the period 1 January 2007 to 31 December 2011. Data from the laboratory information system were used to classify the test requisitioners. General practitioners requisitioned 60 % of all chlamydia tests and 63 % of all positive tests. Youth health services requisitioned 13 % of all tests and 22 % of positive tests; gynaecologists in private practice, 12 % of all tests and 5 % of positive tests. Overall, 26 % of specimens were from women over the age of 30 with 2.2 % testing positive, and 82 % of these specimens were submitted by general practitioners or gynaecologists in private practice. Twenty-three per cent of specimens were from men, and 78 % of these were collected in general practice. Knowledge of who requisitions chlamydia testing and of whom is important for planning and improving chlamydia diagnosis, treatment and contact tracing. In this study from Norway, we found that doctors in general practice play a key role in diagnosing and treating chlamydia. The testing of women over the age of 30 by general practitioners and gynaecologists in private practice probably leads to unnecessary use of resources and should be reduced.