Screening for genital Chlamydia trachomatis in teenagers attending a family planning youth clinic: a prevalence study using a strand displacement assay on urine samples

Abstract

Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection. Rates are highest in the 16-24-year-old age group. Untreated it can be a significant cause of morbidity. At least 50% of men and 70% of women with C. trachomatis are asymptomatic.

Study aims: The aims of the study were: To determine the prevalence of C. trachomatis. To determine the success of our referral policy to genitourinary medicine (GU clinic). To determine the characteristics of the population with C. trachomatis. To estimate the level of recognition of 'chlamydia' as a concept.

Participants: Attendees at our youth clinic between October 2001 and March 2002.

Methods: Ethical approval was obtained for this ongoing study. All attendees who were sexually active were asked to participate. An information leaflet was provided. Those who agreed to participate answered a questionnaire, which included a number of lifestyle questions, and provided a urine sample for C. trachomatis testing using a strand displacement assay. Positive results were forwarded to the GU clinic, which provided antibiotic therapy, contact tracing and follow-up.

Result: The ongoing study has yielded 616 results with 73 positive (11.9%). To date 66 individuals (90%) have attended the GU clinic and 41 (50%) of the possible 82 partners have responded to contact tracing.

Conclusion: Initial results show a high prevalence of C. trachomatis. There is a low condom usage despite a reasonable level of awareness of 'chlamydia'. Contact tracing has not been as successful as anticipated. When the study is complete, various service provision questions will need to be answered, such as the ability to treat the disease in a dedicated youth clinic, making urine testing for C. trachomatis by strand displacement assay (SDA) more widespread, the problem of follow-up, screening for associated sexually transmitted infections (STIs) and contact tracing in a relatively less mobile and less empowered population.