[Promoting primary care screening for Chlamydia trachomatis infection]

Area of Science:

• Public Health
• Infectious Diseases
• General Practice

Background:

• Lower urogenital tract Chlamydia trachomatis (Ct) is the most prevalent bacterial STI in Europe, particularly among young, sexually active individuals.
• Asymptomatic infections and delayed diagnosis contribute to Ct's spread and potential severity, underscoring the need for early detection strategies.
• Opportunistic screening in primary care settings is crucial for managing this public health challenge.

Purpose of the Study:

• To implement and evaluate a multifaceted intervention aimed at enhancing opportunistic Chlamydia trachomatis screening by general practitioners (GPs).
• To assess the impact of academic detailing and self-testing kits on Ct screening practices in young patients within the Alpes-Maritimes region.
• To identify facilitators and barriers to implementing Ct screening interventions in primary care.

Main Methods:

• A randomized controlled trial involving 105 GPs who received academic detailing, educational tools, and patient self-testing kits.
• GPs were tasked with screening 10 patients over a six-month period.
• Quantitative data (screening rates) and qualitative data (GP interviews, focus groups) were collected for assessment.

Main Results:

• The intervention group demonstrated a significantly higher screening rate increase (73%) compared to the general trend, with statistical significance (p = 0.02).
• Of the patients screened (48%), 12 tested positive for Chlamydia trachomatis via PCR.
• Qualitative analysis revealed key factors that facilitated or hindered the screening process.

Conclusions:

• The intervention proved to be impactful and feasible within a primary care setting, receiving positive feedback from participating GPs.
• GPs successfully utilized identified facilitators to overcome obstacles encountered during the intervention.
• Sustained efforts will involve making evaluated tools and training resources available online to support GPs in promoting Ct screening and sexual health education.