Interventions for increasing chlamydia screening in primary care: a review.

Samitha Ginige,Francis J Bowden,Marcus Y Chen,Christopher K Fairley,Jane S Hocking

doi:10.1186/1471-2458-7-95

Abstract

BackgroundDespite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low. Our aim was to review the evidence for specific interventions aimed at increasing chlamydia screening rates in primary care.MethodsA Medline search was conducted for controlled trials that assessed the effectiveness of interventions aimed at improving chlamydia screening rates in primary health care settings. The Medline search was done for studies in English published prior to December 2005 using the following key words: chlamydia, screening, intervention, primary care and GPs. In addition, the references cited in the articles were reviewed. Studies in English published prior to December 2005 were reviewed.ResultsFour controlled studies met the inclusion criteria – 3 were randomized studies and one was not. Strategies to increase screening rates included the use of educational packages targeting primary care physicians and the correction of barriers to screening within clinic systems. In 3 studies, the intervention was associated with an increase in screening rates of between 100% and 276% (p < 0.04). In the fourth study, the intervention was associated with a significant attenuation in declining screening rates over time (4% versus 34% decline, p = 0.04).ConclusionThere are only a limited number of randomized or controlled studies that demonstrate improved chlamydia screening of younger women in primary care.

Highlights

Despite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low
In Australia, over 80% of women aged 16–24 years visit a general practitioner (GP) at least once a year for any reason and most chlamydial infections are diagnosed in general practice [9]
We review studies aimed at identifying specific interventions to increase chlamydia screening rates in primary care

Summary

Introduction

Despite guidelines recommending opportunistic chlamydia screening of younger women, screening rates in some countries remain low. Chlamydia trachomatis is the most commonly reported bacterial sexually transmitted infection (STI) in the world [1]. This is of concern as untreated infection can lead to serious complications such as pelvic inflammatory disease, tubal infertility and ectopic pregnancy. BMC Public Health 2007, 7:95 http://www.biomedcentral.com/1471-2458/7/95 for chlamydia reduces the prevalence of infection and the incidence of pelvic inflammatory disease [4,5]. Opportunistic screening of sexually active females less than 25 years of age for chlamydia in primary care has been recommended in a number of industrialized countries [6,8]. Despite the widespread availability of non-invasive testing methods for chlamydia and single dose therapy using azithromycin, chlamydia screening rates have overall remained low [9]

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