The value of mass screening for chlamydia control in high prevalence communities

The social context and epidemiology of STIs in remote communities in Northern Canada was examined. These communities have a persistently high reported incidence of gonorrhoea and chlamydial infection. They remain in the hyperendemic phase of the N. gonorrhoeae and C. trachomatis epidemics. They are ethnically and culturally homogeneous and contain no readily identifiable core groups, making it impossible to distinguish between spread and maintenance networks. Mass screening of the adult population can reduce the reservoir of C. trachomatis infection under these circumstances. It is particularly important to target men in settings such as this where women are routinely screened in antenatal and family planning clinics.