The rate of re-infection within a major city community based
chlamydia screening programme
Chlamydia Screening Programme, North Liverpool PCT, Liverpool,
ntroduction The Chlamydia Screening Programme in
Liverpool UK started in June 2004 and has so far screened 18,000 people. The
programme is aimed at young men and women aged 24 years and under. As well as
screening opportunistically, clients who test positive are offered treatment, as
are current and previous partners. Inevitably, though the programme is
successful we still see instances of re-infection. Current local guidance is to
use azithromycin as first line treatment but erythromycin where there is a risk
Aims and objectives To show the rate of re-infection of
those tested over a 12 month period with a 6 month follow up. To discover the
percentages of clients who were initially treated for chlamydia and became
re-infected. To identify factors which will help reduce the re-infection rate.
Methods The study looked at chlamydia tests completed
from 1st September 2004 to 31st August 2005 with follow up till February 2006.
All data was sourced from the Chlamydia Database and case note auditing. The
chlamydia prevalence in the audit period was 13%.
Results Out of 1,284 clients tested and treated 116 (9%)
were re-tested and of those 49 (i.e. 4% of the original clients tested) had been
re-infected. Hence of those re-tested 42% were positive and 58% negative.
Reasons for re-infection differed. The most common reason was sexual intercourse
with an untreated partner. Other reasons included unprotected sexual intercourse
with a new partner, sex too soon after treatment, poor compliance with
antibiotics and gastro-intestinal upset.
Conclusion Effective health education can help to reduce
the incidences of re-infection. Safer sex should be discussed at treatment
consultation and instructions should be given on how to take antibiotics
correctly. Using azithromycin as first choice for women even with a risk of
pregnancy, as done in many other services, may help to reduce problems with
treatment compliance. If clients are aware of chlamydia risks and they attend
for re-testing then this greater awareness of the sexual health consequences of
chlamydia can be seen as a success of the programme.