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RESEARCH ARTICLE

Novel approach to an effective community-based chlamydia screening program within the routine operation of a primary healthcare service

Monika Buhrer-Skinner A B C , Reinhold Muller A , Arun Menon B and Rose Gordon B
+ Author Affiliations
- Author Affiliations

A Anton Breinl Centre for Public Health and Tropical Medicine, James Cook University, Townsville, Qld 4811, Australia.

B Townsville Sexual Health Service, North Ward Health Campus, Townsville, Qld 4810, Australia.

C Corresponding author. Email: monika.buhrerskinner@jcu.edu.au

Sexual Health 6(1) 51-56 https://doi.org/10.1071/SH08019
Submitted: 7 March 2008  Accepted: 13 October 2008   Published: 23 February 2009

Abstract

Background: A prospective study was undertaken to develop an evidence-based outreach chlamydia screening program and to assess the viability and efficiency of this complementary approach to chlamydia testing within the routine operations of a primary healthcare service. Methods: A primary healthcare service based in Townsville, Queensland, Australia, identified high-prevalence groups for chlamydia in the community. Subsequently, a series of outreach clinics were established and conducted between August 2004 and November 2005 at a defence force unit, a university, high school leavers’ festivities, a high school catering for Indigenous students, youth service programs, and backpacker accommodations. Results: All target groups were easily accessible and yielded high participation. Chlamydia prevalence ranged between 5 and 15% for five of the six groups; high school leavers had no chlamydia. All participants were notified of their results and all positive cases were treated (median treatment interval 7 days). Five of the six assessed groups were identified as viable for screening and form the basis for the ongoing outreach chlamydia screening program. Conclusion: The present study developed an evidence-based outreach chlamydia screening program and demonstrated its viability as a complementary approach to chlamydia testing within the routine operations of the primary healthcare service, i.e. without the need for additional funding. It contributes to the evidence base necessary for a viable and efficient chlamydia management program. Although the presented particulars may not be directly transferable to other communities or health systems, the general two-step approach of identifying local high-risk populations and then collaborating with community groups to access these populations is.

Additional keyword: Australia.


Acknowledgements

The authors thank the staff at the Townsville Sexual Health Service for conducting the outreach clinics and recruiting participants into the study and the Queensland Health Pathology Service for logistical support and expedient provision of test results. The study was financially supported by a Queensland Health Nursing Research grant.


References


[1] Centers for Disease Control and Prevention, Division of STD Prevention.STD surveillance 2004 national profile: Chlamydia. Atlanta: Centers for Disease Control and Prevention; 2004. Available online at: http://www.cdc.gov/std/stats04/chlamydia.htm [verified 3 November 2008].

[2] Cassell JA,  Mercer CH,  Sutcliffe L,  Petersen I,  Islam A,  Brook MG, et al. Trends in sexually transmitted infections in general practice 1990–2000: population based study using data from the UK general practice research database. BMJ 2006; 332 332–4.
Crossref | GoogleScholarGoogle Scholar | PubMed | [verified 3 November 2008].

[4] Quinlivan JA,  Petersen RW,  Gurrin LC. High prevalence of chlamydia and Pap-smear abnormalities in pregnant adolescents warrants routine screening. Aust N Z J Obstet Gynaecol 1998; 38 254–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed | [verified 3 November 2008].

[20] Roche Diagnostics.Cobas Amplicor operator’s manual: Chlamydia trachomatis test 5. Pleasanton, CA: Roche Molecular Systems Inc; 2003

[21] Hart G,  Duncan B,  Fenton K. Chlamydia screening and sexual health. Sex Transm Infect 2002; 78 396–7.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[22] Chen MY. Screening for Chlamydia trachomatis infection: Are men the forgotten reservoir? Med J Aust 2003; 179 124–5.
PubMed |

[23] Miller G,  McDermott R,  McCulloch B,  Fairley CK,  Muller R. Predictors of the prevalence of bacterial STI among young disadvantaged Indigenous people in north Queensland, Australia. Sex Transm Infect 2003; 79 332–5.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[24] Simms I,  Mallinson H,  Hopwood J,  Webb AMC,  Fenton K,  Pimenta J. Detection or treatment: which outcome measure? Sex Transm Infect 2001; 77 150.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[25] Wong D,  Berman SM,  Furness BW,  Gunn RA,  Taylor M,  Peterman TA. Time to treatment for women with chlamydia or gonococcal infection: A comparative evaluation of sexually transmitted disease clinics in 3 US cities. Sex Transm Dis 2005; 32 194–8.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[26] Chen MY,  Ryder N,  Donovan B. Completeness and timeliness of treatment for chlamydia within a sexual health service. Int J STD AIDS 2004; 15 762–4.
Crossref | GoogleScholarGoogle Scholar | PubMed |

[27] Van Valkengoed IGM,  Postma MJ,  Morre SA,  van den Brule AJC,  Meijer CJLM,  Bouter LM, et al. Cost effectiveness analysis of a population based screening programme for asymptomatic Chlamydia trachomatis infections in women by means of home obtained urine specimens. Sex Transm Infect 2001; 77 276–82.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[28] Honey E,  Augood C,  Templeton A,  Russell I,  Paavonen J,  Mårdh P-A, et al. Cost effectiveness of screening for Chlamydia trachomatis: a review of published studies. Sex Transm Infect 2002; 78 406–13.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |

[29] Turner KM,  Adams EJ,  Lamontagne DS,  Emmett L,  Baster K,  Edmunds WJ. Modelling the effectiveness of chlamydia screening in England. Sex Transm Infect 2006; 82 496–502.
Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |