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

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.

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.

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.

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.