Abstract
The feasibility of opportunistic screening of urogenital infections with Chlamydia trachomatis was assessed in a cross-sectional study in 2012, in two cantons of south-western Switzerland: Vaud and Valais. Sexually active persons younger than 30 years, not tested for C. trachomatis in the last three months, were invited for free C. trachomatis testing by PCR in urine or self-applied vaginal swabs. Of 2,461 consenting participants, 1,899 (77%) were women and all but six (0.3%) submitted a sample. Forty-seven per cent of female and 25% of male participants were younger than 20 years. Overall, 134 (5.5%) of 2,455 tested participants had a positive result and were followed up. Seven per cent of all candidates for screening were not invited, 10% of invited candidates were not eligible, 15% of the eligible candidates declined participation, 5% of tested participants testing positive were not treated, 29% of those treated were not retested after six months and 9% of those retested were positive for C. trachomatis. Opportunistic C. trachomatis testing proved technically feasible and acceptable, at least if free of charge. Men and peripheral rural regions were more difficult to reach. Efforts to increase testing and decrease dropout at all stages of the screening procedure are necessary.
Highlights
Chlamydia trachomatis is a frequent cause of sexually transmitted urogenital infections [1]
This study explores the feasibility of opportunistic testing for C. trachomatis control, the third level in the European Centre for Disease Prevention and Control (ECDC) recommendations
Free C. trachomatis testing in first-void urine or, for women according to personal preference, self-applied vaginal swabs, was offered from February to August 2012 to all persons younger than 30 years in public health services representative of the whole territory
Summary
Chlamydia trachomatis is a frequent cause of sexually transmitted urogenital infections [1]. Complications, rarely life threatening, can be substantial, especially for women. They include pelvic inflammatory disease, chronic abdominal pain, ectopic pregnancy, tubal sterility [2] and possibly a higher risk for adverse pregnancy outcomes [3,4]. Treatment of urogenital infections caused by C. trachomatis can prevent complications, at least in the short term [6,7]. The pooled risk ratio for all-cause pelvic inflammatory disease after one year of followup in women invited to have C. trachomatis screening in four randomised controlled trials was 0.64 (95% confidence interval (CI): 0.45–0.90) [2]. It has been hypothesised that early treatment may impede development of immunity and favour future re-infection [10,11]
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