Completeness of and duration of time before treatment after screening women for Chlamydia trachomatis infections.

Abstract

To assess the proportion of women with verified treatment after positive screening tests for C. trachomatis infection and to evaluate the duration of time until treatment. Retrospective cohort analysis linking the date of a positive genital C. trachomatis test with the documented date of treatment. Family planning, sexually transmitted disease, obstetrical/gynecologic, adolescent, and walk-in clinics in Philadelphia from March 1, 1994 through December 31, 1995. Included 4,158 women with screening tests positive for C. trachomatis. Documented treatment of chlamydia-infected women and duration of time between initial clinic visit and therapy. Over a 21-month period, 4,158 women had endocervical screening tests positive for C. trachomatis. Twenty-four percent of these women were treated presumptively (on the day of specimen collection), with sexually transmitted disease clinics yielding the highest percentage (70.9%) of presumptively treated patients. Of the 3,143 chlamydia-positive women not treated presumptively, treatment was subsequently verified in 96.2%. The median interval between screening and treatment was 21 days. Private adolescent clinics had the lowest median interval of 14 days between screening and treatment, whereas public family planning clinics showed the largest median screening to treatment interval of 26 days. Large-scale screening programs in public health settings can bring nearly all C. trachomatis-infected patients to treatment. However, new strategies are needed to shorten the duration of time before treatment of selected subsets of women who screen positive for C. trachomatis.