Primary health care providers surveyed commonly misinterpret ‘first void urine’ for chlamydia screening
M. Josephine Lusk A , Ruby Uddin B , Mark Ferson C D , William Rawlinson E and Pam Konecny A F GA Short Street Sexual Health Centre, Department of Immunology, Allergy & Infectious Diseases, St George Hospital, Kogarah, NSW 2217, Australia.
B St Mary’s Hospital, Department of Genitourinary Medicine, Imperial College Healthcare National Health Service Trust, London, W2 1NY, UK.
C Public Health Unit, South Eastern Sydney Illawarra Health, Randwick, NSW 2031, Australia.
D School of Public Health and Community Medicine, University of NSW, Randwick, NSW 2052, Australia.
E Virology Division, Department of Microbiology (SEALS), Prince of Wales Hospital, Randwick NSW 2031, Australia; School of Biotechnology and Biomolecular Sciences and School of Medical Sciences, University of NSW, Randwick, NSW 2052, Australia.
F Faculty of Medicine, University of New South Wales, Randwick, NSW 2052, Australia.
G Corresponding author. Email: pam.konecny@sesiahs.health.nsw.gov.au
Sexual Health 6(1) 91-93 https://doi.org/10.1071/SH08087
Submitted: 26 November 2008 Accepted: 15 January 2009 Published: 23 February 2009
Abstract
An open question survey of general practitioners (GP) and hospital emergency department (ED) doctors revealed that the term ‘FVU’ (first void urine) used for urine chlamydia testing, is ambiguous, potentially leading to incorrect urine sample collection and barriers to effective screening. The results of this survey indicate that only 4.3% (95% confidence interval [CI] 0.5–14.5%) of GP and 6.9% (95% CI 0.9–22.8%) of ED doctors respectively, correctly interpreted the meaning of FVU. The majority of clinicians surveyed misunderstood ‘FVU’ to require the first urine void of the day, accounting for 68.1% (95% CI 52.9–80.9%) of GP responses and 37.9% (95% CI 20.7–57.7%) of ED doctors responses. This highlights the need for clarification and standardisation of terminology used in urine chlamydia screening for health care providers, in order to optimise strategies for diagnosis and control of the ongoing chlamydia epidemic.
Additional keywords: General Practitioners, polymerase chain reaction, STD screening.
Acknowledgements
We thank all GP and ED doctors who took part in this survey. We also thank Dr Judith Gardner, Sexual Health Physician, Short Street Centre and Family Planning NSW, for reviewing the manuscript.
[1]
[2] Regan DG, Wilson DP, Hocking JS. Coverage is the key for effective screening of Chlamydia trachomatis in Australia. J Infect Dis 2008; 198 349–58.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[3]
[4] Marrazzo JM, Whittington WH, Celum CL, Handsfield HH, Clark A, Cles L, et al. Urine-based screening for Chlamydia trachomatis in men attending sexually transmitted disease clinics. Sex Transm Dis 2001; 28 219–25.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[5] Gaydos CA, Theodore M, Dalesio N, Wood BJ, Quinn TC. Comparison of three nucleic acid amplification tests for detection of Chlamydia trachomatis in urine specimens. J Clin Microbiol 2004; 42 3041–5.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[6] Livengood CH, Wrenn JW. Evaluation of COBAS AMPLICOR (Roche): accuracy in detection of Chlamydia trachomatis and Neisseria gonorrhoea by co amplification of endocervical specimens. J Clin Microbiol 2001; 39 2928–32.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[7] Paukku M, Puolakkainen M, Apter D, Hirvonen S, Paavonen J. First-void testing for Chlamydia trachomatis by polymerase chain reaction in asymptomatic women. Sex Transm Dis 1997; 24 343–6.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[8] Chernesky M, Jang D, Chong S, Sellors J, Mahony J. Impact of urine collection order on the ability of assays to identify Chlamydia trachomatis infections in men. Sex Transm Dis 2003; 30 345–7.
| Crossref | GoogleScholarGoogle Scholar | CAS | PubMed |
[9]
[10]
[11] Ginige S, Fairley CK, Hocking JS, Bowden FJ, Chen MY. Interventions for increasing Chlamydia screening in primary care: a review. BMC Public Health 2007; 7 95.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
