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Temporal Patterns in Chlamydia Repeat Testing in Massachusetts.

Elizabeth C Dee1, Katherine K Hsu2, Benjamin A Kruskal3

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Chlamydia test-of-cure and test-of-reinfection rates remain low, with no improvement observed between 2010-2015. Adherence to repeat testing guidelines presents an opportunity for public health intervention to reduce chlamydia transmission.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • National guidelines advocate for chlamydia test-of-cure and test-of-reinfection to prevent adverse outcomes.
  • Understanding trends in repeat testing and positivity rates is crucial, especially in private healthcare settings.

Purpose of the Study:

  • To analyze temporal trends in chlamydia test-of-cure and test-of-reinfection rates.
  • To assess repeat testing and positivity rates among pregnant females, non-pregnant females, and males.

Main Methods:

  • Utilized electronic health record data from three Massachusetts practice groups (2010-2015).
  • Employed generalized estimating equations to analyze repeat testing rates after positive chlamydia tests.
  • Compared intervals to first repeat tests across different demographic groups.

Main Results:

  • Test-of-cure rates were 37% for pregnant females; test-of-reinfection rates were 39% (pregnant females), 18% (non-pregnant females), and 9% (males).
  • No significant increases in test-of-cure or test-of-reinfection rates were observed from 2010 to 2015.
  • Repeat positive test results occurred in 16% of pregnant females, 15% of non-pregnant females, and 16% of males.

Conclusions:

  • Chlamydia test-of-cure and test-of-reinfection rates are suboptimal and have not improved over time.
  • Significant opportunities exist to enhance adherence to recommended chlamydia repeat testing protocols.