Abstract
BackgroundScreening and active case finding for Chlamydia trachomatis (CT) is recommended to prevent reproductive morbidity. However insight in community prevalence of gonococcal infections and co-infections with Neisseria gonorrhoea (NG) is lacking.MethodsNested study within a large population-based Chlamydia Screening Pilot among 21.000 persons 15–29 year. All CT-positive (166) and a random sample of 605 CT-negative specimens were as well tested for gonococcal infection.ResultsOverall Chlamydia prevalence in the Pilot was 2.0% (95% CI: 1.7–2.3), highest in very urban settings (3.2%; 95% CI: 2.4–4.0) and dependent of several risk factors. Four gonococcal infections were found among 166 participants with CT infection (4/166 = 2.4%; 95% CI: 0.1%–4.7%). All four had several risk factors and reported symptoms. Among 605 CT-negative persons, no infection with NG could be confirmed.ConclusionA low rate of co-infections and a very low community prevalence of gonococcal infections were found in this population based screening programme among young adults in the Netherlands. Population screening for asymptomatic gonococcal infections is not indicated in the Netherlands. Although co-infection with gonorrhoea among CT-positives is dependent on symptoms and well-known algorithms for elevated risks, we advise to test all CT-positives also for NG, whether symptomatic or asymptomatic.
Highlights
Screening and active case finding for Chlamydia trachomatis (CT) is recommended to prevent reproductive morbidity
Infection was associated with self-reported ethnicity, number of sex partners and symptoms
16/605 were reactive for Neisseria gonorrhoea (NG), but none could be confirmed with the additional confirmatory test. In this large national representative population based Chlamydia Screening in the Netherlands among 21.000 persons we have reported an overall CT prevalence of 2.0 %
Summary
Screening and active case finding for Chlamydia trachomatis (CT) is recommended to prevent reproductive morbidity. Nucleic Acid Amplication tests (NAATs) on self-obtained specimens (urine, vaginal swabs) make it feasible to detect these infections in a very effective manner, inside as well as outside conventional clinic settings [4,5,6]. These new technologies prelude a potential revolution in our ability to control Sexually Transmitted Infections (STI). In many countries screening or active case finding for Chlamydia trachomatis (CT) is recommended. In the Netherlands health care seeking behaviour for STI is geared towards primary care, the General Practitioner (GP) addressing the majority of the STI-related problems[7]
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