Screening for Chlamydia in general practice: a literature review and summary of the evidence

Genital Chlamydia trachomatis infection is the commonest curable sexually transmitted disease (STD) in England and Wales and is one of the chief causes of pelvic inflammatory disease (PID) in women. Infection in women is complicated by the fact that the majority of women with this infection are asymptomatic. It is feasible for general practitioners (GPs) to test for this infection, and there has been debate as to which is the most appropriate screening strategy. In the absence of any national UK guidelines, the purpose of this systematic literature review is to appraise critically and summarize the evidence for screening for genital chlamydia infection in sexually active women attending UK general practice. The four areas to be reviewed are: prevalence of genital chlamydia infection in women attending UK general practice; evidence for routine screening of women attending general practice; evidence for selective screening of women attending general practice; evidence for screening women requesting termination of pregnancy (TOP) or intrauterine device (IUD) insertion. This review should allow GPs and public health practitioners to become aware of the quality of evidence underlying various screening strategies and inform any local guideline development.