Re-screening Chlamydia trachomatis positive subjects: a comparison of practices between an STI clinic, general practitioners and gynaecologists.

OBJECTIVES

Re-screening after an initial positive test is a highly effective strategy to identify new Chlamydia trachomatis positive cases. Here, we evaluate adherence to international re-screening guidelines and the re-screening positive rates among sexual healthcare providers.

METHODS

Passive retrospective cohort data were obtained from our STI clinic (South Limburg, Netherlands) and from the public laboratory that performs the majority of C trachomatis tests (September 2006-September 2010) conducted in the eastern South Limburg area. We assessed trends in re-screening after 3-12 months among young (16-25-year-old) and older women and men and evaluated differences between providers using multivariate regression analyses.

RESULTS

The positive rates in C trachomatis screening varied from 2-9% depending on the type of provider. At the STI clinic, subsequent re-screening was performed in 33% (382/1144) of patients, and 19% of re-screening cases were positive (74/382). Similar rates were observed for gynaecologists (re-screening 30%, 54/178; re-screening positive rate 15%, 8/51); re-screening rates were lower for general practitioners (23%, 144/625, p<0.01), but the positive rate in re-screening was similar (17%, 25/144). At the STI clinic, the re-screening rate was higher for older females (p<0.01) and older males (p<0.01) than for young females. The re-screening rate for young male patients increased over time (p=0.04). General practitioners re-screened young women more often than young (p<0.01) and older (p<0.01) men.

CONCLUSIONS

Positive rates were high for all care providers when re-screening patients. However, re-screening practices are suboptimal and differ between providers, arguing for improved adherence to current C trachomatis control guidelines.